Provider Demographics
NPI:1558757286
Name:LUCAS, LASHAUNDA (LCSWA)
Entity Type:Individual
Prefix:
First Name:LASHAUNDA
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HABERSHAM CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3070
Mailing Address - Country:US
Mailing Address - Phone:252-544-1164
Mailing Address - Fax:252-210-3281
Practice Address - Street 1:2109 SAINT ANDREW ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-2149
Practice Address - Country:US
Practice Address - Phone:252-641-0990
Practice Address - Fax:252-641-9997
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0093671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical