Provider Demographics
NPI:1568899706
Name:LYNCH, LEKESHIA MILTANETTE (LCSW-A)
Entity Type:Individual
Prefix:
First Name:LEKESHIA
Middle Name:MILTANETTE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 SCHOOL HOUSE CMNS # 140
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-7510
Mailing Address - Country:US
Mailing Address - Phone:704-699-9375
Mailing Address - Fax:
Practice Address - Street 1:140 CABARRUS AVE W
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5150
Practice Address - Country:US
Practice Address - Phone:704-918-5494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NCC0110791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1114421310Medicaid
NC1568899706Medicaid