Provider Demographics
NPI:1023032257
Name:WHITFIELD, MICHELLE LEIGH (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEIGH
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N SECOND ST
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-2401
Mailing Address - Country:US
Mailing Address - Phone:919-812-2214
Mailing Address - Fax:919-304-9546
Practice Address - Street 1:301 N SECOND ST
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-2401
Practice Address - Country:US
Practice Address - Phone:919-812-2214
Practice Address - Fax:919-304-9546
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0041811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106432Medicaid
NC6003117Medicaid