Provider Demographics
NPI:1437581279
Name:STROMAN, LETHA LUCINDA (LCASA)
Entity Type:Individual
Prefix:
First Name:LETHA
Middle Name:LUCINDA
Last Name:STROMAN
Suffix:
Gender:F
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 FREIDA LN
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6464
Mailing Address - Country:US
Mailing Address - Phone:704-231-2483
Mailing Address - Fax:185-587-3553
Practice Address - Street 1:418 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4380
Practice Address - Country:US
Practice Address - Phone:980-320-1058
Practice Address - Fax:704-887-5311
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-03
Last Update Date:2013-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2618-A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)