Provider Demographics
NPI:1760285985
Name:JAUNKERRA LEIGH
Entity type:Organization
Organization Name:JAUNKERRA LEIGH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAUNKERRA
Authorized Official - Middle Name:SANDERS
Authorized Official - Last Name:LEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-355-8524
Mailing Address - Street 1:1633 NEW GARDEN RD # 2015
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2001
Mailing Address - Country:US
Mailing Address - Phone:336-355-8524
Mailing Address - Fax:
Practice Address - Street 1:6867 KEENELAND DRIVE
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377
Practice Address - Country:US
Practice Address - Phone:336-355-8524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty