Provider Demographics
NPI:1861622946
Name:LOCK MASSEY, NATALKA AQUINAIRIA
Entity type:Individual
Prefix:MRS
First Name:NATALKA
Middle Name:AQUINAIRIA
Last Name:LOCK MASSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4086 BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6604
Mailing Address - Country:US
Mailing Address - Phone:919-806-9001
Mailing Address - Fax:919-295-4313
Practice Address - Street 1:4086 BARRETT DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6604
Practice Address - Country:US
Practice Address - Phone:919-806-9001
Practice Address - Fax:919-295-4313
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC270596269Medicaid