Provider Demographics
NPI:1568503308
Name:LUCAS, DEBORAH ANN (LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 SHANNONDALE RD
Mailing Address - Street 2:
Mailing Address - City:MAYPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16240-3328
Mailing Address - Country:US
Mailing Address - Phone:814-379-3304
Mailing Address - Fax:
Practice Address - Street 1:240 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1829
Practice Address - Country:US
Practice Address - Phone:814-226-8669
Practice Address - Fax:814-226-5329
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional