Provider Demographics
NPI:1831493741
Name:HUFFMAN, LINWOOD EARL (LPCA)
Entity Type:Individual
Prefix:MR
First Name:LINWOOD
Middle Name:EARL
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 SHIPYARD BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8070
Mailing Address - Country:US
Mailing Address - Phone:910-791-9625
Mailing Address - Fax:
Practice Address - Street 1:2250 SHIPYARD BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8070
Practice Address - Country:US
Practice Address - Phone:910-791-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8213101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA8213Medicaid
NCA8213OtherAPPLYING FOR MEDICAID PIN NUMBER