Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 175T00000X | Peer Specialist | | | | No |
| 2 | 207R00000X | Internal Medicine | | | | No |
| 3 | 251B00000X | Case Management | | 870442 | NORTH CAROLINA | No |
| 4 | 251S00000X | Community/Behavioral Health | | | | No |
| 5 | 261QP2300X | Clinic/Center | Primary Care | | | No |
| 6 | 363A00000X | Physician Assistant | | | | No |
| 7 | 363LP2300X | Nurse Practitioner | Primary Care | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 11997122 | OTHER | NORTH CAROLINA | HEALTHY BLUE OF NC (MEDICAID - LESLIE WARE) |
| 2 | 13014156 | OTHER | NORTH CAROLINA | MULTIPLAN - LESLIE WARE |
| 3 | 6022957 | OTHER | NORTH CAROLINA | AETNA |
| 4 | 1245236249 | MEDICAID | NORTH CAROLINA | |
| 5 | 2628388 | OTHER | NORTH CAROLINA | WELLCARE |
| 6 | 5561347 | OTHER | NORTH CAROLINA | AETNA - LESLIE WARE |
| 7 | 4785515 | OTHER | NORTH CAROLINA | CIGNA - DR. ALICIA HOWARD |
| 8 | P10007481725 | OTHER | NORTH CAROLINA | CAROLINA COMPLETE HEALTH - LESLIE WARE |
