Provider Demographics
NPI:1174308423
Name:LANIER, JOYCE ANN
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:LANIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 PETER GRANT RD
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-8960
Mailing Address - Country:US
Mailing Address - Phone:919-332-6052
Mailing Address - Fax:
Practice Address - Street 1:2424 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7505
Practice Address - Country:US
Practice Address - Phone:252-557-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLACAS-24894101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)