Healthcare Provider Details

I. General information

NPI: 1265344956
Provider Name (Legal Business Name): ALESHA PERKINS CLINICAL AND CONSULTING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 GAYLORD DR
AXTON VA
24054
US

IV. Provider business mailing address

11845 RETAIL DR # 1076
WAKE FOREST NC
27587-7352
US

V. Phone/Fax

Practice location:
  • Phone: 919-480-8927
  • Fax:
Mailing address:
  • Phone: 919-480-8927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALESHA PERKINS
Title or Position: OWNER
Credential: LCSW
Phone: 919-480-8927