Provider Demographics
NPI:1255369708
Name:LLOYD, LEE B (LCSW)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:B
Last Name:LLOYD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 RANDALL PKWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2829
Mailing Address - Country:US
Mailing Address - Phone:910-791-5719
Mailing Address - Fax:910-799-8180
Practice Address - Street 1:5010 RANDALL PKWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2829
Practice Address - Country:US
Practice Address - Phone:910-791-5719
Practice Address - Fax:910-799-8180
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0004501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC457497000OtherMAGELLAN
A314813OtherVALUE OPTIONS GROUP
NC52369OtherBLUE CROSS BLUE SHIELD NC
62292OtherCIGNA
NC6003065Medicaid
066687OtherVALUE OPTIONS
NC4279054OtherAETNA
B5447OtherMEDCOST
066687OtherVALUE OPTIONS