Provider Demographics
NPI:1811581507
Name:LUCAS, CHRISTOPHER M (LGSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:M
Last Name:LUCAS
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 20TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1850
Mailing Address - Country:US
Mailing Address - Phone:304-696-8700
Mailing Address - Fax:304-696-8701
Practice Address - Street 1:800 20TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-1850
Practice Address - Country:US
Practice Address - Phone:304-696-8700
Practice Address - Fax:304-696-8701
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00945678104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker