Healthcare Provider Details

I. General information

NPI: 1750869632
Provider Name (Legal Business Name): JOYIA M LUCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18402 ALLSPICE DR
GERMANTOWN MD
20874-2011
US

IV. Provider business mailing address

306 W REDWOOD ST # 4466
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 301-686-6586
  • Fax:
Mailing address:
  • Phone: 301-686-6586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLC18123
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: