Provider Demographics
NPI:1962975417
Name:WOODWARD, LUCINDA EMILY (PHD)
Entity type:Individual
Prefix:DR
First Name:LUCINDA
Middle Name:EMILY
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3358 W VINCENNES TRL
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167-8211
Mailing Address - Country:US
Mailing Address - Phone:128-443-9188
Mailing Address - Fax:
Practice Address - Street 1:3358 W VINCENNES TRL
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-8211
Practice Address - Country:US
Practice Address - Phone:812-883-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043239A101YM0800X
390200000X
IN20043239B103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300030825Medicaid