Provider Demographics
NPI:1407556509
Name:LEADING LIGHT SERVICES, PLLC
Entity Type:Organization
Organization Name:LEADING LIGHT SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-275-0608
Mailing Address - Street 1:3206 HERITAGE TRADE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4487
Mailing Address - Country:US
Mailing Address - Phone:919-275-0608
Mailing Address - Fax:919-263-8538
Practice Address - Street 1:3206 HERITAGE TRADE DR STE 100
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4487
Practice Address - Country:US
Practice Address - Phone:919-275-0608
Practice Address - Fax:919-263-8538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty