| Doctor Name: | MR. CLYDE VANCE LOCKLEAR |
| NPI Number: | 1013051044 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 3073 |
| Business Practice Address: | 915 S Main St Ste I Laurinburg, NC - 283524700 |
| Business Phone Number: | 9102773212 |
| Business Fax Number: | 9102773214 |
| Mailing Address: | 915 S Main St Ste I, LAURINBURG |
| State: | NC |
| Postal Code: | 283524700 |
| Phone Number: | 9102773212 |
| Fax Number: | 9102773214 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 3073 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |