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NPI Code Detail

MEDICARE: KENDALL SUE LUCAS MSW

MEDICARE: KENDALL SUE LUCAS MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1154528271
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL SUE LUCAS MSW
Provider Business Mailing Address
First Line : 230 NORTH RD
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-1328
Country : US
Telephone Number : 845-486-2703
Fax Number : 845-471-3406
Provider Business Practice Location Address
First Line : 2 REIMER AVE
Second Line :
City : DOVER PLAINS
State : NY
Zip : 12522-5136
Country : US
Telephone Number : 845-877-4100
Fax Number : 845-877-4112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2007
Last Update Date : 07/08/2007

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Directions to “ KENDALL SUE LUCAS MSW” Practice Location

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