Provider Demographics
NPI:1841420460
Name:LOCKARD, DIANE JOHNSTON (LPC-S)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:JOHNSTON
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:OLA
Other - Middle Name:DIANE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4800 NETA LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-4152
Mailing Address - Country:US
Mailing Address - Phone:940-642-6581
Mailing Address - Fax:
Practice Address - Street 1:4800 NETA LN
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-4152
Practice Address - Country:US
Practice Address - Phone:940-766-4534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19010101YP2500X
TX3872101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional