Provider Demographics
NPI:1508255217
Name:STAPLES, LAKREISHA KENYATTA (LPCA)
Entity Type:Individual
Prefix:MS
First Name:LAKREISHA
Middle Name:KENYATTA
Last Name:STAPLES
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 TRIAD CENTER DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9073
Mailing Address - Country:US
Mailing Address - Phone:336-931-1800
Mailing Address - Fax:
Practice Address - Street 1:7900 TRIAD CENTER DR
Practice Address - Street 2:SUITE 350
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9073
Practice Address - Country:US
Practice Address - Phone:336-931-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11382101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health