Provider Demographics
NPI:1437575438
Name:LOCKWOOD, JOHN (CASAC, LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:LOCKWOOD
Suffix:
Gender:M
Credentials:CASAC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 NORTH STREET
Mailing Address - Street 2:SAINT VINCENT WESTCHESTER 1-DOTY UNIT
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528
Mailing Address - Country:US
Mailing Address - Phone:914-925-5536
Mailing Address - Fax:914-925-5162
Practice Address - Street 1:275 NORTH STREET
Practice Address - Street 2:SAINT VINCENT WESTCHESTER 1-DOTY UNIT
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528
Practice Address - Country:US
Practice Address - Phone:914-925-5536
Practice Address - Fax:914-925-5162
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10938101YA0400X
NY000983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10938OtherCASAC