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General NPI Number Information
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NPI Number | 1851714208
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Entity Type | Individual
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Provider Name | WILLIAM LEE LOCKHART LPC
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Gender | Male
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 1410 CALISTA DR
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City | BETHEL
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State | AK
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Zip | 99559
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Country | US
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Telephone | 907-543-6730
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Fax | 907-543-6712
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Provider Business Mailing Address
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Address Line | PO BOX 528
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City | BETHEL
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State | AK
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Zip | 99559-0528
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Country | US
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Telephone | 907-543-6730
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Fax | 907-543-6712
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2936
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License Number State | AL
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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 | 151580
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License Number State | AK
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