Provider Demographics
NPI:1851422505
Name:MCLUCAS, LINDSAY BETH (NCSP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:BETH
Last Name:MCLUCAS
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13910 N 176TH LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7848
Mailing Address - Country:US
Mailing Address - Phone:623-444-4313
Mailing Address - Fax:
Practice Address - Street 1:7702 N 39TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-6419
Practice Address - Country:US
Practice Address - Phone:602-347-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool