Provider Demographics
NPI:1104009257
Name:LUCEY, CARA K (PSYD)
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:K
Last Name:LUCEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:CARA
Other - Middle Name:K
Other - Last Name:ANSHUTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:46-078 EMEPELA PL APT K103
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3962
Mailing Address - Country:US
Mailing Address - Phone:808-387-7615
Mailing Address - Fax:808-247-8598
Practice Address - Street 1:615 PIIKOI ST STE 105
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3139
Practice Address - Country:US
Practice Address - Phone:808-596-8433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist