| Laura Lockwood Llc | |
|
2041 46th St Los Alamos NM 87544-1718 | |
| (505) 500-4282 | |
| Not Available |
| Full Name | Laura Lockwood Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2041 46th St, Los Alamos, New Mexico |
| Authorized Official Name and Position | Laura D Lockwood (OWNER) |
| Authorized Official Contact | 5055004282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Lockwood Llc 2041 46th St Los Alamos NM 87544-1718 Ph: (505) 500-4282 | Laura Lockwood Llc 2041 46th St Los Alamos NM 87544-1718 Ph: (505) 500-4282 |
| NPI Number | 1902421761 |
|---|---|
| Provider Enumeration Date | 06/08/2020 |
| Last Update Date | 06/08/2020 |
| Certification Date | 06/08/2020 |
| Medicare PECOS PAC ID | 1850712357 |
|---|---|
| Medicare Enrollment ID | O20200610000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902421761 | NPI | - | NPPES |
| 1093011975 | Other | OH | NPI TYPE I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Laura Denise Lockwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093011975 PECOS PAC ID: 7517199482 Enrollment ID: I20200611001214 |
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