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NPI Code Detail

MEDICARE: JAREE LUCAS

MEDICARE: JAREE LUCAS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1750747481
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAREE LUCAS
Provider Business Mailing Address
First Line : 4220 N GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-1831
Country : US
Telephone Number : 314-534-6624
Fax Number : 314-535-4394
Provider Business Practice Location Address
First Line : 4220 N GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-1831
Country : US
Telephone Number : 314-534-6624
Fax Number : 314-535-4394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2016
Last Update Date : 01/11/2016

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1659823417 — MRS. APRIL GORSKI MA, LPC
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Directions to “ JAREE LUCAS ” Practice Location

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