Provider Demographics
NPI:1326278482
Name:LUCEY, ELIZABETH MARION
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARION
Last Name:LUCEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BROOKS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2248
Mailing Address - Country:US
Mailing Address - Phone:508-479-6368
Mailing Address - Fax:
Practice Address - Street 1:338 MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5043
Practice Address - Country:US
Practice Address - Phone:781-246-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical