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General NPI Number Information
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NPI Number | 1063886802
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Entity Type | Individual
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Provider Name | LUCAS CARSTO LPC
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Gender | Male
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 35 HALL SUITE SUITE 304
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City | PHOENIXVILLE
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State | PA
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Zip | 19464
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Country | US
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Telephone | 610-590-7999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 281
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City | GILBERTSVILLE
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State | PA
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Zip | 19525-0281
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC010008
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License Number State | PA
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