Provider Demographics
NPI:1558725945
Name:LOCKLEAR, ROSE LOWERY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:LOWERY
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5821 LADY WAY
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9394
Mailing Address - Country:US
Mailing Address - Phone:910-733-9594
Mailing Address - Fax:
Practice Address - Street 1:5821 LADY WAY
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-9394
Practice Address - Country:US
Practice Address - Phone:910-733-9594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0016631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical