Healthcare Provider Details

I. General information

NPI: 1821798497
Provider Name (Legal Business Name): LUCAS THOMPSON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CAROLINA AVE
EWING NJ
08618-1608
US

IV. Provider business mailing address

28 SPRING ST UNIT 377
PRINCETON NJ
08542-6901
US

V. Phone/Fax

Practice location:
  • Phone: 609-264-6277
  • Fax:
Mailing address:
  • Phone: 609-264-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37AC00586400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: