Healthcare Provider Details

I. General information

NPI: 1518647726
Provider Name (Legal Business Name): LOCKWOOD SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 SOUTH COUNTY COMMONS WAY SUITE D-10
WAKEFIELD RI
02879
US

IV. Provider business mailing address

35 SOUTH COUNTY COMMONS WAY SUITE D-10
WAKEFIELD RI
02879
US

V. Phone/Fax

Practice location:
  • Phone: 401-556-9399
  • Fax: 401-429-6142
Mailing address:
  • Phone: 401-556-9399
  • Fax: 401-429-6142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LEA BETH LOCKWOOD
Title or Position: PRESIETN/PSYCHOLOGIST
Credential: PHD
Phone: 401-556-9399