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General NPI Number Information
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NPI Number | 1932445004
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Entity Type | Individual
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Provider Name | ALEESHA HERRING M.A. LCAS-A
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Gender | Female
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 2018 FORT BRAGG RD STE 120-A
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-7037
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Country | US
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Telephone | 910-339-1928
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Fax | 910-339-4650
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Provider Business Mailing Address
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Address Line | 183 SAMP RD
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City | PEMBROKE
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State | NC
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Zip | 28372-8986
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3134-A
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License Number State | NC
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