Provider Demographics
NPI:1659880292
Name:LUCAS, CARA MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:MARIE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 S 85TH CT
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1006
Mailing Address - Country:US
Mailing Address - Phone:708-257-3296
Mailing Address - Fax:
Practice Address - Street 1:85 REVERE DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-8001
Practice Address - Country:US
Practice Address - Phone:708-257-3296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-17-27592103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst