Provider Demographics
NPI:1669944146
Name:LUCAS, MARGARET PEGGY (PMHNP)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:PEGGY
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MR
Other - First Name:MARGARET
Other - Middle Name:PEGGY
Other - Last Name:OWUSU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0704
Mailing Address - Country:US
Mailing Address - Phone:518-429-3072
Mailing Address - Fax:518-785-0342
Practice Address - Street 1:500 BALLTOWN RD BLDG 12D
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-2247
Practice Address - Country:US
Practice Address - Phone:518-388-1848
Practice Address - Fax:518-370-7375
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402412363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health