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General NPI Number Information
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NPI Number | 1194916288
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Entity Type | Individual
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Provider Name | GERALD W LANKFORD JR. MBA, MACC, MDIV, LPC
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Gender | Male
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 1601 JONES FRANKLIN RD SUITE 104
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City | RALEIGH
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State | NC
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Zip | 27606-3379
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Country | US
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Telephone | 919-851-1527
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Fax | 919-851-3555
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Provider Business Mailing Address
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Address Line | 1601 JONES FRANKLIN RD SUITE 104
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City | RALEIGH
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State | NC
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Zip | 27606-3379
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Country | US
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Telephone | 919-851-1527
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Fax | 919-851-3555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 6654
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6654
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License Number State | NC
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