Provider Demographics
NPI:1740868884
Name:LAWING, LOGAN
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:LAWING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-0749
Mailing Address - Country:US
Mailing Address - Phone:704-869-2088
Mailing Address - Fax:
Practice Address - Street 1:910 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3449
Practice Address - Country:US
Practice Address - Phone:704-748-0616
Practice Address - Fax:704-240-9980
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0000332287512255A2300X
NC2279103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer