Provider Demographics
NPI:1265004949
Name:LOCKLEAR, LAKEN COURTNEY (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:LAKEN
Middle Name:COURTNEY
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 1:2230 MCPHAIL RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-8020
Mailing Address - Country:US
Mailing Address - Phone:910-225-9293
Mailing Address - Fax:
Practice Address - Street 1:2940 BREEZEWOOD AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5520
Practice Address - Country:US
Practice Address - Phone:910-748-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0162761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical