Provider Demographics
NPI:1558088831
Name:FLOYD, JOHN E (MS, LCMHC-A)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:FLOYD
Suffix:
Gender:M
Credentials:MS, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 WILLOW PARK DR APT 312
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-8977
Mailing Address - Country:US
Mailing Address - Phone:718-578-3981
Mailing Address - Fax:
Practice Address - Street 1:17714 KINGS POINT DR STE B
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6929
Practice Address - Country:US
Practice Address - Phone:704-997-5397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health