Kristin Ivey Locklear, MSW, LCSWA
Individual provider Active NPI Clinical Social Worker · Winnabow, NC
NPI 1639558802 · NPPES record last updated May 21, 2015
Key facts
- NPI
- 1639558802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P007904 (NC)
- Practice address
- 721 Governors Rd SE
Winnabow, NC 28479-5123 - Phone
- (910) 612-5702
- NPI assigned
- May 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P007904 | NC | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P007904 | NC | Yes |
Addresses
Primary practice location
721 Governors Rd SE
Winnabow, NC 28479-5123
Mailing address
721 Governors Rd SE
Winnabow, NC 28479-5123
Other providers in Winnabow, NC
- Donna Flynn Hudson
- Essence Armani James
- Beverly L Johnson
- Navin Kingston
- Courtney Johnson Lee
- Sandra Luczynski
- L'Toynya McKoy Messick
- Nichols Transportation
- Nichols Transportation
- Path to Wellness & Resilience, PLLC
All providers in Winnabow, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.