Provider Demographics
NPI:1518235878
Name:LUCAS, EMILY LOUISE (LCPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 1ST AVE E STE 16
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4965
Mailing Address - Country:US
Mailing Address - Phone:509-435-2404
Mailing Address - Fax:866-498-7530
Practice Address - Street 1:307 1ST AVE E STE 16
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4965
Practice Address - Country:US
Practice Address - Phone:509-435-2404
Practice Address - Fax:866-498-7530
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional