Provider Demographics
NPI:1780794586
Name:MITCHAM, LLOYD WILLIAM JR (LMFT)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:WILLIAM
Last Name:MITCHAM
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 REDMON CT
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-8490
Mailing Address - Country:US
Mailing Address - Phone:828-464-7580
Mailing Address - Fax:828-464-1879
Practice Address - Street 1:1375 LENOIR RHYNE BLVD SE
Practice Address - Street 2:PIEDMONT CENTER SUITE 122
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-5171
Practice Address - Country:US
Practice Address - Phone:828-328-8808
Practice Address - Fax:828-464-1879
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC420106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist