Basic Information
| Provider Information | |||||||||
| NPI: | 1306231048 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BADALUCCA | ||||||||
| FirstName: | LESLIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2187 | ||||||||
| Address2: | |||||||||
| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287792187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286313973 | ||||||||
| FaxNumber: | 8286319280 | ||||||||
| Practice Location | |||||||||
| Address1: | 28 WALNUT ST STE 6 | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287863246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285061853 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2015 | ||||||||
| LastUpdateDate: | 04/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 11732 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | 11732 | NC | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.