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General NPI Number Information
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NPI Number | 1346591161
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Entity Type | Individual
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Provider Name | JOEY DOUGLAS LOCKMAN LCAS
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Gender | Male
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 325 N MARIETTA ST
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City | GASTONIA
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State | NC
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Zip | 28052-2331
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Country | US
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Telephone | 704-862-6663
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Fax | 704-869-7336
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | GASTONIA
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State | NC
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Zip | 28053-0370
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Country | US
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Telephone | 704-862-6663
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Fax | 704-869-7336
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1030
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License Number State | NC
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