Provider Demographics
NPI:1528196201
Name:LAWSON SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:LAWSON SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:336-372-6083
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675-0189
Mailing Address - Country:US
Mailing Address - Phone:336-372-6083
Mailing Address - Fax:336-372-6087
Practice Address - Street 1:85 WILLIS STREET
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-0085
Practice Address - Country:US
Practice Address - Phone:336-372-6083
Practice Address - Fax:336-372-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health