Provider Demographics
NPI:1639887714
Name:LOCK AND KEY WELLNESS AND COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:LOCK AND KEY WELLNESS AND COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHAUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARK-DARIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-765-5588
Mailing Address - Street 1:4200 MCFARLAND BLVD
Mailing Address - Street 2:PO BOX 1665
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-6665
Mailing Address - Country:US
Mailing Address - Phone:205-765-5588
Mailing Address - Fax:
Practice Address - Street 1:13738 BRANDON JAMES AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35475-1883
Practice Address - Country:US
Practice Address - Phone:205-765-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty