Provider Demographics
NPI:1982707113
Name:LUCAS, MORGAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 ENCLAVE CIR APT 211
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6199
Mailing Address - Country:US
Mailing Address - Phone:740-802-4399
Mailing Address - Fax:814-394-5075
Practice Address - Street 1:1006 N BOWEN RD STE 200E-H
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2826
Practice Address - Country:US
Practice Address - Phone:740-802-4399
Practice Address - Fax:817-394-5075
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
TX34930103T00000X
NC3822103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3286502Medicaid
NC3822OtherPSYCHOLOGY LICENSE
TX34930OtherPSYCHOLOGY LICESNE
OH23307055Medicaid