Provider Demographics
NPI:1831819747
Name:WEBSTER, JEALISIA LESHE
Entity type:Individual
Prefix:
First Name:JEALISIA
Middle Name:LESHE
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 FALL LN APT 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4603
Mailing Address - Country:US
Mailing Address - Phone:919-664-9089
Mailing Address - Fax:
Practice Address - Street 1:12339 WAKE UNION CHURCH RD STE 111
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4512
Practice Address - Country:US
Practice Address - Phone:036-091-9867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical