Provider Demographics
NPI:1245007897
Name:LOCKLEAR, LINDSAY ELIZABETH (MS, LCMHC-A)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ELIZABETH
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:MS, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5637 FAIRWAY COVE CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-3164
Mailing Address - Country:US
Mailing Address - Phone:336-407-1421
Mailing Address - Fax:
Practice Address - Street 1:163 STRATFORD CT STE 166
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1833
Practice Address - Country:US
Practice Address - Phone:336-831-4051
Practice Address - Fax:336-436-9123
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19383101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional