Provider Demographics
NPI:1275957177
Name:LOCKLEAR, HEATHER LYNN (LPC; LCASA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:LPC; LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12100 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-2535
Mailing Address - Country:US
Mailing Address - Phone:910-827-9988
Mailing Address - Fax:910-266-9966
Practice Address - Street 1:1112 ATKINSON ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4723
Practice Address - Country:US
Practice Address - Phone:910-610-4222
Practice Address - Fax:910-610-4228
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20373101YA0400X
NC10630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)