Healthcare Provider Details

I. General information

NPI: 1336563220
Provider Name (Legal Business Name): ANITA LUCAS MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 CEDAR LAKE DR
HUBER HEIGHTS OH
45424-1588
US

IV. Provider business mailing address

2026 CEDAR LAKE DR
HUBER HEIGHTS OH
45424-1588
US

V. Phone/Fax

Practice location:
  • Phone: 937-532-3414
  • Fax:
Mailing address:
  • Phone: 937-532-3414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberS0025982
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: