1740307123 NPI number — MS. GLORIA HARBIN LOCKMAN M.S.W.

Table of content: MS. GLORIA HARBIN LOCKMAN M.S.W. (NPI 1740307123)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740307123 NPI number — MS. GLORIA HARBIN LOCKMAN M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOCKMAN
Provider First Name:
GLORIA
Provider Middle Name:
HARBIN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740307123
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
341 BUGLE BOY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLOWHEE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28723-8133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-293-1060
Provider Business Mailing Address Fax Number:
828-293-0841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CHILDREN'S DEVELOPMENTAL SERVICES AGENCY OF THE SMOKIES
Provider Second Line Business Practice Location Address:
87 BONNIE LANE
Provider Business Practice Location Address City Name:
SYLVA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28779
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-631-3900
Provider Business Practice Location Address Fax Number:
828-631-9200
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C003286 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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