Healthcare Provider Details

I. General information

NPI: 1104704923
Provider Name (Legal Business Name): DEBRA DENISE SINCLAIR LCMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W 4TH ST
LUMBERTON NC
28358-5530
US

IV. Provider business mailing address

200 E 13TH ST
LUMBERTON NC
28358-4729
US

V. Phone/Fax

Practice location:
  • Phone: 910-736-8996
  • Fax: 843-400-5045
Mailing address:
  • Phone: 910-816-2458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA21775
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: