Provider Demographics
NPI:1851597744
Name:LUCAS, DESTINY KNIGHT (LPC)
Entity Type:Individual
Prefix:
First Name:DESTINY
Middle Name:KNIGHT
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DESTINY
Other - Middle Name:KNIGHT
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4840 W PANTHER CREEK DR
Mailing Address - Street 2:#210
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3527
Mailing Address - Country:US
Mailing Address - Phone:713-303-2723
Mailing Address - Fax:
Practice Address - Street 1:4840 W PANTHER CREEK DR
Practice Address - Street 2:#210
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3527
Practice Address - Country:US
Practice Address - Phone:713-303-2723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional