Provider Demographics
NPI:1417125329
Name:PARR, LESLEY M (LCAS)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:M
Last Name:PARR
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 POPLARWOOD CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-6445
Mailing Address - Country:US
Mailing Address - Phone:919-787-6131
Mailing Address - Fax:919-571-2932
Practice Address - Street 1:1012 OBERLIN ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1135
Practice Address - Country:US
Practice Address - Phone:919-787-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1230101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)