Provider Demographics
NPI:1720356736
Name:MATTHEW, LUCIA CAROL
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:CAROL
Last Name:MATTHEW
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 1:2496 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-4905
Mailing Address - Country:US
Mailing Address - Phone:702-576-2444
Mailing Address - Fax:
Practice Address - Street 1:730 N EASTERN AVENUE, SUITE 110
Practice Address - Street 2:FAMILY GUIDANCE AND WELLNESS NETWORK
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89156
Practice Address - Country:US
Practice Address - Phone:702-586-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health