Provider Demographics
NPI:1255545091
Name:LOCKWOOD, LEA (LICSW)
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4342
Mailing Address - Country:US
Mailing Address - Phone:401-821-4100
Mailing Address - Fax:410-823-9180
Practice Address - Street 1:889 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4342
Practice Address - Country:US
Practice Address - Phone:401-821-4100
Practice Address - Fax:410-823-9180
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW018081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI413855OtherRI BLUE CHIP PROVIDER #
RI0000032080OtherRI BLUE CROSS PROVIDER #