Provider Demographics
NPI:1750548533
Name:LUCAS, HEIDI LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LYNN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1067
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25402-1067
Mailing Address - Country:US
Mailing Address - Phone:304-263-7023
Mailing Address - Fax:304-264-0508
Practice Address - Street 1:99 TAVERN RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2890
Practice Address - Country:US
Practice Address - Phone:304-263-7023
Practice Address - Fax:304-264-0508
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1893101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health