Provider Demographics
NPI:1508244492
Name:LUCAS, CYNTHIA (MA, LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MA, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 WILLIAMSON RD STE 6
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9138
Mailing Address - Country:US
Mailing Address - Phone:704-582-3381
Mailing Address - Fax:
Practice Address - Street 1:542 WILLIAMSON RD STE 6
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9138
Practice Address - Country:US
Practice Address - Phone:704-582-3381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA106491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical