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General NPI Number Information
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NPI Number | 1780013037
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Entity Type | Organization
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Legal Business Name | LEWISVILLE FAMILY COUNSELING, PLLC
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 6620 SHALLOWFORD RD SUITE 200
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City | LEWISVILLE
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State | NC
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Zip | 27023-9504
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Country | US
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Telephone | 336-757-0258
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Fax | 336-945-0342
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Provider Business Mailing Address
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Address Line | 6620 SHALLOWFORD RD SUITE 200
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City | LEWISVILLE
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State | NC
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Zip | 27023-9504
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Country | US
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Telephone | 336-757-0258
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Fax | 336-945-0342
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Authorized Official
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Title or Position | LPC
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Name | JENNIFER LOCKLEAR
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Credential |
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Telephone | 336-757-0258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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