Provider Demographics
NPI:1578054813
Name:LUCAS, ELAINE MARIE
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:MARIE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2917
Mailing Address - Country:US
Mailing Address - Phone:508-235-9881
Mailing Address - Fax:508-674-5404
Practice Address - Street 1:1561 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2917
Practice Address - Country:US
Practice Address - Phone:508-235-9881
Practice Address - Fax:508-674-5404
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110873104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker