Provider Demographics
NPI:1609551464
Name:LUCAS, ASHLEY LEEANN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LEEANN
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 1:115 SOUTHPARK PL
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-7098
Mailing Address - Country:US
Mailing Address - Phone:240-452-2404
Mailing Address - Fax:
Practice Address - Street 1:1135 GREGG HWY NW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6341
Practice Address - Country:US
Practice Address - Phone:803-641-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker