Provider Demographics
NPI:1689931297
Name:PITT, LESLIE LAUGHLIN (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:LAUGHLIN
Last Name:PITT
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19224 PENINSULA SHORES DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7578
Mailing Address - Country:US
Mailing Address - Phone:704-655-7430
Mailing Address - Fax:704-655-0069
Practice Address - Street 1:134 JACKSON ST STE 201
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-9612
Practice Address - Country:US
Practice Address - Phone:704-237-3847
Practice Address - Fax:866-553-1142
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8015A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist