Provider Demographics
NPI:1902376551
Name:CABINESS, LEKICHA MONIQUE (BSQMHP)
Entity Type:Individual
Prefix:MRS
First Name:LEKICHA
Middle Name:MONIQUE
Last Name:CABINESS
Suffix:
Gender:F
Credentials:BSQMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HICKS ST. SUITE 303
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23868
Mailing Address - Country:US
Mailing Address - Phone:434-848-5823
Mailing Address - Fax:
Practice Address - Street 1:102 HICKS ST. SUITE 303
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23868
Practice Address - Country:US
Practice Address - Phone:434-848-5823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3061-03-001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health