Provider Demographics
NPI:1932445004
Name:HERRING, ALEESHA (MA LCAS-A)
Entity Type:Individual
Prefix:MS
First Name:ALEESHA
Middle Name:
Last Name:HERRING
Suffix:
Gender:F
Credentials:MA LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 SAMP RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-8986
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2018 FORT BRAGG RD STE 120-A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-7037
Practice Address - Country:US
Practice Address - Phone:910-339-1928
Practice Address - Fax:910-339-4650
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3134-A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)