Provider Demographics
NPI:1316373764
Name:LUCAS, STEPHANIE HANNAH (MS, LMFT, CADC-I)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:HANNAH
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MS, LMFT, CADC-I
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:HANNAH
Other - Last Name:HEUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2577 NE COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7752
Mailing Address - Country:US
Mailing Address - Phone:541-322-7500
Mailing Address - Fax:541-322-7565
Practice Address - Street 1:244 NW KINGWOOD AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1688
Practice Address - Country:US
Practice Address - Phone:541-322-7500
Practice Address - Fax:541-322-7565
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORT1188106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT1188OtherLMFT