Provider Demographics
NPI:1225363179
Name:LUCAS, CHRISTINA FRANCES (SAC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:FRANCES
Last Name:LUCAS
Suffix:
Gender:F
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 SCHOFIELD AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-2377
Mailing Address - Country:US
Mailing Address - Phone:715-355-0671
Mailing Address - Fax:
Practice Address - Street 1:1699 SCHOFIELD AVE STE 116
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-2377
Practice Address - Country:US
Practice Address - Phone:715-355-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15523-131101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)