Healthcare Provider Details

I. General information

NPI: 1851986780
Provider Name (Legal Business Name): JERRICA LUCERO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8336 MONROE RD RM 120
LAMBERTVILLE MI
48144-9340
US

IV. Provider business mailing address

8336 MONROE RD RM 120
LAMBERTVILLE MI
48144-9340
US

V. Phone/Fax

Practice location:
  • Phone: 734-807-0162
  • Fax: 888-700-7159
Mailing address:
  • Phone: 734-807-0162
  • Fax: 888-700-7159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401226181
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2607208
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: