Provider Demographics
NPI:1932889946
Name:WESTMAN, LUCAS (LICSW)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:WESTMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:LUCAS
Other - Middle Name:
Other - Last Name:WESTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:169 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3139
Mailing Address - Country:US
Mailing Address - Phone:507-514-4466
Mailing Address - Fax:
Practice Address - Street 1:12 CIVIC CENTER PLZ STE 1615
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-7783
Practice Address - Country:US
Practice Address - Phone:507-345-4679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN284871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical