Provider Demographics
NPI:1801042320
Name:JOSEY, LAKEETRA MCCLAINE (PHD, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAKEETRA
Middle Name:MCCLAINE
Last Name:JOSEY
Suffix:
Gender:F
Credentials:PHD, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-3254
Mailing Address - Country:US
Mailing Address - Phone:215-806-5111
Mailing Address - Fax:
Practice Address - Street 1:410 FOULK RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3820
Practice Address - Country:US
Practice Address - Phone:302-762-2285
Practice Address - Fax:302-654-1317
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00181500363LP0808X
NJ26NR13561200163WP0808X
PASP011243363LP0808X
PARN622390163WP0808X
DEL1-0041743163WP0808X
DEL8-0000114363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health