Provider Demographics
NPI:1205668449
Name:LEAHY, JACQUELINE HELMS (LCSWA)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:HELMS
Last Name:LEAHY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:DARLENE
Other - Last Name:WOOTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1826 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-6595
Mailing Address - Country:US
Mailing Address - Phone:828-774-6013
Mailing Address - Fax:
Practice Address - Street 1:2415 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-9691
Practice Address - Country:US
Practice Address - Phone:828-774-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical