Healthcare Provider Details

I. General information

NPI: 1174518567
Provider Name (Legal Business Name): CAROL B LUCE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 COLLEGE AVE
BEAVER PA
15009-2706
US

IV. Provider business mailing address

255 BEAVER ST
BEAVER PA
15009-2835
US

V. Phone/Fax

Practice location:
  • Phone: 724-544-6444
  • Fax: 866-571-4572
Mailing address:
  • Phone: 724-544-6444
  • Fax: 866-571-4572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS005832L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: