Provider Demographics
NPI:1982815692
Name:LAYTON, LAWRENCE K
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:K
Last Name:LAYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 CREEDMOOR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6352
Mailing Address - Country:US
Mailing Address - Phone:919-852-5352
Mailing Address - Fax:919-852-5323
Practice Address - Street 1:5505 CREEDMOOR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6352
Practice Address - Country:US
Practice Address - Phone:919-852-5352
Practice Address - Fax:919-852-5323
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0056541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical