Provider Demographics
NPI:1255799706
Name:RALEIGH, LASHLEY SUSANNE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:LASHLEY
Middle Name:SUSANNE
Last Name:RALEIGH
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 WATERS AVE APT 183
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4972
Mailing Address - Country:US
Mailing Address - Phone:912-777-2713
Mailing Address - Fax:
Practice Address - Street 1:315 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3628
Practice Address - Country:US
Practice Address - Phone:912-777-2713
Practice Address - Fax:912-335-3927
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA052202604OtherDRIVER'S LICENSE