Provider Demographics
NPI:1114366549
Name:LOCKLEAR, BIRGIT J (LSCW-C)
Entity Type:Individual
Prefix:MRS
First Name:BIRGIT
Middle Name:J
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:LSCW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16475 STEEPLECHASE CT
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20637-2868
Mailing Address - Country:US
Mailing Address - Phone:301-538-3753
Mailing Address - Fax:301-609-6741
Practice Address - Street 1:4545 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3045
Practice Address - Country:US
Practice Address - Phone:301-609-6729
Practice Address - Fax:301-609-6741
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical