Provider Demographics
NPI:1730762824
Name:PRIDE, LESIA CURRIE (LCSWA)
Entity type:Individual
Prefix:
First Name:LESIA
Middle Name:CURRIE
Last Name:PRIDE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 S MEBANE ST STE 302
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-6591
Mailing Address - Country:US
Mailing Address - Phone:336-264-6893
Mailing Address - Fax:
Practice Address - Street 1:1708 S MEBANE ST STE 302
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6591
Practice Address - Country:US
Practice Address - Phone:336-264-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0143411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty