Provider Demographics
NPI:1508580788
Name:HIGDON, LESLIE NICOLE (LMHCA)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:NICOLE
Last Name:HIGDON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:MISS
Other - First Name:LESLIE
Other - Middle Name:NICOLE
Other - Last Name:WELBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3908 SEDGEGROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-7928
Mailing Address - Country:US
Mailing Address - Phone:336-561-1892
Mailing Address - Fax:
Practice Address - Street 1:3719 W MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1378
Practice Address - Country:US
Practice Address - Phone:336-701-0267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18089101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor