Provider Demographics
NPI:1174291728
Name:LOCKLEAR, HILLARY DAWN (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:DAWN
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 HAYES LOCKLEAR RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-8232
Mailing Address - Country:US
Mailing Address - Phone:910-384-5284
Mailing Address - Fax:
Practice Address - Street 1:184 HAYES LOCKLEAR RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8232
Practice Address - Country:US
Practice Address - Phone:910-384-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP013432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty