Provider Demographics
NPI:1972516276
Name:LOCKWOOD, BONNIE O (LPC)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:O
Last Name:LOCKWOOD
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1988 TOM BELL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-7075
Mailing Address - Country:US
Mailing Address - Phone:706-348-8674
Mailing Address - Fax:706-348-8676
Practice Address - Street 1:1988 TOM BELL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-7075
Practice Address - Country:US
Practice Address - Phone:706-348-8674
Practice Address - Fax:706-348-8676
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582379283OtherTAX ID