Provider Demographics
NPI:1992078505
Name:LCG THERAPY, PLLC
Entity type:Organization
Organization Name:LCG THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NEJLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:919-895-0978
Mailing Address - Street 1:900 S VANCE ST
Mailing Address - Street 2:OFFICE 300
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4774
Mailing Address - Country:US
Mailing Address - Phone:919-895-0978
Mailing Address - Fax:919-777-2727
Practice Address - Street 1:900 S VANCE ST
Practice Address - Street 2:OFFICE 300
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4774
Practice Address - Country:US
Practice Address - Phone:919-895-0978
Practice Address - Fax:919-777-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7575251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health