Provider Demographics
NPI:1689449795
Name:LECOMPTE, PRISCILLA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:LECOMPTE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5574 GARDEN VILLAGE WAY STE D1
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8581
Mailing Address - Country:US
Mailing Address - Phone:336-817-6372
Mailing Address - Fax:
Practice Address - Street 1:5574 GARDEN VILLAGE WAY STE D1
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8581
Practice Address - Country:US
Practice Address - Phone:336-817-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health