Provider Demographics
NPI:1477345346
Name:WRIGHT, LUCAS ROBERT
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:ROBERT
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19925 SWEETGUM CIR APT 32
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-3783
Mailing Address - Country:US
Mailing Address - Phone:773-951-0079
Mailing Address - Fax:
Practice Address - Street 1:19925 SWEETGUM CIR APT 32
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-3783
Practice Address - Country:US
Practice Address - Phone:773-951-0079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician