Provider Demographics
NPI:1922866052
Name:LUCAS, KAYLE DICKIE
Entity Type:Individual
Prefix:MRS
First Name:KAYLE
Middle Name:DICKIE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 COUNTY HIGHWAY 24
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-8841
Mailing Address - Country:US
Mailing Address - Phone:205-446-8860
Mailing Address - Fax:
Practice Address - Street 1:1318 ALFORD AVE STE 101
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3167
Practice Address - Country:US
Practice Address - Phone:205-784-8410
Practice Address - Fax:866-635-1797
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4561G1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical