Provider Demographics
NPI:1730116278
Name:LUCIA, CARLA (M ED LPC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:LUCIA
Suffix:
Gender:F
Credentials:M ED LPC
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:PROFFITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 13006
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-3006
Mailing Address - Country:US
Mailing Address - Phone:919-345-6103
Mailing Address - Fax:919-835-4322
Practice Address - Street 1:4010 BARRETT DR STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6650
Practice Address - Country:US
Practice Address - Phone:919-345-6103
Practice Address - Fax:919-835-4322
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102562Medicaid
1424KOtherBCBS