Provider Demographics
NPI:1427185909
Name:LEIGHTON, DEBORAH A (LCSW, LCAS)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:A
Last Name:LEIGHTON
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6317 SOUTH BEND LANE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4659
Mailing Address - Country:US
Mailing Address - Phone:704-814-9850
Mailing Address - Fax:704-814-9850
Practice Address - Street 1:5200 PARK RD
Practice Address - Street 2:SUITE 200-C
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3650
Practice Address - Country:US
Practice Address - Phone:704-814-9850
Practice Address - Fax:704-631-4578
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC370101YA0400X
NCC0039191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003191Medicaid