Provider Demographics
NPI:1609959394
Name:LUCAS, LYNN ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 COLONIAL COURT
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563
Mailing Address - Country:US
Mailing Address - Phone:574-316-3300
Mailing Address - Fax:574-316-3385
Practice Address - Street 1:509 COLONIAL COURT
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563
Practice Address - Country:US
Practice Address - Phone:574-316-3300
Practice Address - Fax:574-316-3385
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003925A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical