Provider Demographics
NPI:1124469879
Name:BIBBS, EARLISHA LEACH (LCMHC)
Entity type:Individual
Prefix:
First Name:EARLISHA
Middle Name:LEACH
Last Name:BIBBS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:EARLISHA
Other - Middle Name:EARLISHA
Other - Last Name:LEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:600 LYNNDALE CT STE F
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5443
Mailing Address - Country:US
Mailing Address - Phone:252-353-8001
Mailing Address - Fax:252-353-7923
Practice Address - Street 1:600 LYNNDALE CT STE F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5443
Practice Address - Country:US
Practice Address - Phone:252-353-8001
Practice Address - Fax:252-353-7923
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health