Healthcare Provider Details

I. General information

NPI: 1689705741
Provider Name (Legal Business Name): CURTIS LUCAS PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 OLD LOUISBURG RD
RALEIGH NC
27604-1376
US

IV. Provider business mailing address

127 HILDA GRACE LN
CARY NC
27519-8757
US

V. Phone/Fax

Practice location:
  • Phone: 919-856-7616
  • Fax:
Mailing address:
  • Phone: 919-856-4616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2653
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number0748
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: