Provider Demographics
NPI:1023015864
Name:LANCASTER, JOHN M (LPC, LSATP, CSAC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:LPC, LSATP, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24416-2432
Mailing Address - Country:US
Mailing Address - Phone:540-319-1014
Mailing Address - Fax:
Practice Address - Street 1:1844 OAK AVE
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:VA
Practice Address - Zip Code:24416-2432
Practice Address - Country:US
Practice Address - Phone:540-319-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710000717101YA0400X
VA0718000006101YA0400X
VA0701002063101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945271Medicaid