Provider Demographics
NPI:1013233220
Name:LUCIER, JEFF EDWARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:EDWARD
Last Name:LUCIER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W BRIDGE ST
Mailing Address - Street 2:STE 8
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447-1540
Mailing Address - Country:US
Mailing Address - Phone:775-463-6597
Mailing Address - Fax:775-463-6598
Practice Address - Street 1:215 W BRIDGE ST
Practice Address - Street 2:STE 8
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-1540
Practice Address - Country:US
Practice Address - Phone:775-463-6597
Practice Address - Fax:775-463-6598
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01663-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical