Provider Demographics
NPI:1922887454
Name:LUCADEMA, HEATHER (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LUCADEMA
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 STIPSONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270-3919
Mailing Address - Country:US
Mailing Address - Phone:609-780-5546
Mailing Address - Fax:
Practice Address - Street 1:899 BAYSHORE RD
Practice Address - Street 2:
Practice Address - City:VILLAS
Practice Address - State:NJ
Practice Address - Zip Code:08251-2780
Practice Address - Country:US
Practice Address - Phone:609-886-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC062166001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical