Provider Demographics
NPI:1982306015
Name:LUCAS, MICHAEL (LMFT-A)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LUCAS
Suffix:
Gender:M
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19911 RIVERTON RANCH DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2817
Mailing Address - Country:US
Mailing Address - Phone:936-718-3169
Mailing Address - Fax:
Practice Address - Street 1:13131 FRY RD STE E
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3339
Practice Address - Country:US
Practice Address - Phone:346-616-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health