Provider Demographics
NPI:1851016810
Name:ELMORE, LUCAS A (T-LMFT)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:A
Last Name:ELMORE
Suffix:
Gender:M
Credentials:T-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MIDLAKE DR STE C
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-3089
Mailing Address - Country:US
Mailing Address - Phone:865-327-6603
Mailing Address - Fax:
Practice Address - Street 1:200 MIDLAKE DR STE C
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-3089
Practice Address - Country:US
Practice Address - Phone:865-327-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist