Healthcare Provider Details

I. General information

NPI: 1023935517
Provider Name (Legal Business Name): DR. JOSHUA CARL LUCAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 ORCHARD TRACE WAY
RALEIGH NC
27610-5644
US

IV. Provider business mailing address

2888 ORCHARD TRACE WAY
RALEIGH NC
27610-5644
US

V. Phone/Fax

Practice location:
  • Phone: 984-284-4004
  • Fax:
Mailing address:
  • Phone: 984-284-4004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18503
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: