Healthcare Provider Details

I. General information

NPI: 1104720333
Provider Name (Legal Business Name): LOCK AND CO. INTEGRATED CLINICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 OLD PLANTATION DR SW
CONCORD NC
28027-8846
US

IV. Provider business mailing address

2626 OLD PLANTATION DR SW
CONCORD NC
28027-8846
US

V. Phone/Fax

Practice location:
  • Phone: 910-736-9971
  • Fax:
Mailing address:
  • Phone: 910-736-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHRISTOPHER GENE LOCKLEAR
Title or Position: CEO/THERAPIST
Credential: PH.D.
Phone: 910-736-9971