Active NPI
Clyde Vance Locklear, LPC
- Mental Health Counselor
- Laurinburg, NC
National Provider Identifier
1013051044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3073
- Practice address
- 915 S Main St Ste I
Laurinburg, NC 28352-4700 - Phone
- (910) 277-3212
- Fax
- (910) 277-3214
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3073 | NC | Primary |
Addresses
Primary practice location
915 S Main St Ste I
Laurinburg, NC 28352-4700
Mailing address
915 S Main St Ste I
Laurinburg, NC 28352-4700
Phone (910) 277-3212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3073 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393459200000",
"number": "1013051044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 S MAIN ST STE I",
"city": "LAURINBURG",
"state": "NC",
"postal_code": "283524700",
"telephone_number": "910-277-3212",
"fax_number": "910-277-3214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 S MAIN ST STE I",
"city": "LAURINBURG",
"state": "NC",
"postal_code": "283524700",
"telephone_number": "910-277-3212",
"fax_number": "910-277-3214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKLEAR",
"first_name": "CLYDE",
"middle_name": "VANCE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2014-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "3073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurinburg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.