Provider Demographics
NPI:1467503342
Name:LUCE, VIRGEN THIRSA (LCSW-R)
Entity Type:Individual
Prefix:PROF
First Name:VIRGEN
Middle Name:THIRSA
Last Name:LUCE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MAIDEN LN APT 1905
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-0001
Mailing Address - Country:US
Mailing Address - Phone:646-522-0611
Mailing Address - Fax:
Practice Address - Street 1:7 LEXINGTON AVE # P2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5517
Practice Address - Country:US
Practice Address - Phone:646-522-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO-214471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical