Provider Demographics
NPI:1134795487
Name:CAIN, PATTI LEIGH (LCSW; LCAS)
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:LEIGH
Last Name:CAIN
Suffix:
Gender:F
Credentials:LCSW; LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 WRIGHTSVILLE AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8463
Mailing Address - Country:US
Mailing Address - Phone:910-386-9546
Mailing Address - Fax:
Practice Address - Street 1:233A MERCHANTS CIR STE 100
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-5419
Practice Address - Country:US
Practice Address - Phone:910-386-9546
Practice Address - Fax:704-831-5308
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0133531041C0700X
NC24424101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)