Provider Demographics
NPI:1578615274
Name:LUCAS, JANEL (LICSW,DCSW,PHD)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LICSW,DCSW,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HUSON STREET
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1401
Mailing Address - Country:US
Mailing Address - Phone:617-696-6809
Mailing Address - Fax:
Practice Address - Street 1:1601 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-425-2040
Practice Address - Fax:617-425-2043
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1056541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical