Provider Demographics
NPI:1174853170
Name:DAUGHTRIDGE, LEIGH HERRING (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:HERRING
Last Name:DAUGHTRIDGE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:ANNE
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 PEE DEE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4932
Mailing Address - Country:US
Mailing Address - Phone:704-986-1500
Mailing Address - Fax:
Practice Address - Street 1:809 TIFFANY BOULEVARD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804
Practice Address - Country:US
Practice Address - Phone:252-442-0333
Practice Address - Fax:252-442-0323
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical