Healthcare Provider Details

I. General information

NPI: 1275452799
Provider Name (Legal Business Name): LEAH LUNSFORD MSW LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 PAVERSTONE DR
RALEIGH NC
27615-4703
US

IV. Provider business mailing address

7406 CHAPEL HILL RD
RALEIGH NC
27607-5077
US

V. Phone/Fax

Practice location:
  • Phone: 919-671-8412
  • Fax:
Mailing address:
  • Phone: 919-671-8412
  • Fax: 919-573-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023934
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: