Provider Demographics
NPI:1982170239
Name:LUCEY, ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:LUCEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 THURSTON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-2838
Mailing Address - Country:US
Mailing Address - Phone:781-439-1560
Mailing Address - Fax:
Practice Address - Street 1:257 AYER RD
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1108
Practice Address - Country:US
Practice Address - Phone:978-774-1846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1437451382OtherADVOCATES COMMUNITY COUNSELING