Provider Demographics
NPI:1275397093
Name:HARE, LUCRECIA (EDS, LAPC)
Entity Type:Individual
Prefix:MRS
First Name:LUCRECIA
Middle Name:
Last Name:HARE
Suffix:
Gender:F
Credentials:EDS, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 MAGNOLIA GARDENS LN NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7503
Mailing Address - Country:US
Mailing Address - Phone:404-484-9081
Mailing Address - Fax:
Practice Address - Street 1:217 E HANOVER ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-1803
Practice Address - Country:US
Practice Address - Phone:848-233-3985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional