Provider Demographics
NPI:1356003503
Name:LUCAJ, LEONORA (LMSW)
Entity Type:Individual
Prefix:
First Name:LEONORA
Middle Name:
Last Name:LUCAJ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CHESTER ARTHUR DR APT 208
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4956
Mailing Address - Country:US
Mailing Address - Phone:482-909-6645
Mailing Address - Fax:
Practice Address - Street 1:450 CHESTER ARTHUR DR APT 208
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4956
Practice Address - Country:US
Practice Address - Phone:248-909-6645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical