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Individual

BENNY LOCKLEAR JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSWA

Contact information

Practice address
432 E LONG AVE STE 2, GASTONIA, NC 28054-2540
(980) 416-3025
(980) 448-3419
Mailing address
432 E LONG AVE STE 2, GASTONIA, NC 28054-2540
(980) 416-3023
(980) 448-3419

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
P018517
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467162065
NC
Enumeration date
12/05/2022
Last updated
07/01/2024
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