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NPI Code Detail

MEDICARE: JOSEPH N LOCKETT LICDC

MEDICARE: JOSEPH N LOCKETT LICDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor85373OH

General Provider Information

NPI Number : 1003085424
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH N LOCKETT LICDC
Provider Business Mailing Address
First Line : 1341 MARKET AVE N
Second Line :
City : CANTON
State : OH
Zip : 44714-2605
Country : US
Telephone Number : 330-453-8252
Fax Number : 330-453-6716
Provider Business Practice Location Address
First Line : 1341 MARKET AVE N
Second Line :
City : CANTON
State : OH
Zip : 44714-2605
Country : US
Telephone Number : 330-453-8252
Fax Number : 330-453-6716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2008
Last Update Date : 02/29/2008

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Directions to “ JOSEPH N LOCKETT LICDC” Practice Location

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