Provider Demographics
NPI:1588264006
Name:WHITFIELD, JOCELYN S (LCAS)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:S
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 WILLIAM BEALE RD
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:NC
Mailing Address - Zip Code:27862-7015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1279 WILLIAM BEALE RD
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:NC
Practice Address - Zip Code:27862-7015
Practice Address - Country:US
Practice Address - Phone:704-771-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-26342101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)