Provider Demographics
NPI:1275206070
Name:LOCKLEAR, HARLEY DEVON (MAED, LCMHCA, NCC)
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:DEVON
Last Name:LOCKLEAR
Suffix:
Gender:M
Credentials:MAED, LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S NASH ST APT 142
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2392
Mailing Address - Country:US
Mailing Address - Phone:910-374-0669
Mailing Address - Fax:
Practice Address - Street 1:1516 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2812
Practice Address - Country:US
Practice Address - Phone:919-642-1031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health