Provider Demographics
NPI:1851281661
Name:LOCKLEAR, ROSA (LCMHCA)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 ELROD RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-8351
Mailing Address - Country:US
Mailing Address - Phone:910-316-6484
Mailing Address - Fax:
Practice Address - Street 1:609 HARRY WEST LN
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8893
Practice Address - Country:US
Practice Address - Phone:910-521-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health