Provider Demographics
NPI:1831932664
Name:PULLIAM, LASHEKA (ALC, NCC)
Entity type:Individual
Prefix:
First Name:LASHEKA
Middle Name:
Last Name:PULLIAM
Suffix:
Gender:F
Credentials:ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 RICHLAND RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-3582
Mailing Address - Country:US
Mailing Address - Phone:334-275-5136
Mailing Address - Fax:
Practice Address - Street 1:1449 RICHLAND RD APT 2B
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-3582
Practice Address - Country:US
Practice Address - Phone:334-275-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health