Provider Demographics
NPI:1689665762
Name:MCCUE, LUCILLE T (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LUCILLE
Middle Name:T
Last Name:MCCUE
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 1:56 CLIFTON COUNTRY ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065
Mailing Address - Country:US
Mailing Address - Phone:518-937-2603
Mailing Address - Fax:
Practice Address - Street 1:56 CLIFTON COUNTRY ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065
Practice Address - Country:US
Practice Address - Phone:518-937-2603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0028481041C0700X
NYR041612-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT163705OtherVALUE OPTIONS
CT246781000OtherMEGALLAN
CT298891OtherMHN
CT140002848-CT-01OtherATHENS BLUE CROSS BLUE SH
CTP3058880OtherOXFORD