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General NPI Number Information
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NPI Number | 1073752549
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Entity Type | Individual
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Provider Name | CYNTHIA LYNN LUCAS LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2009
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Last Update Date | 08/10/2019
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Provider Practice Location Address
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Address Line | 3255 CAHUENGA BLVD W STE 208
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City | LOS ANGELES
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State | CA
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Zip | 90068-1777
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Country | US
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Telephone | 424-333-0107
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Fax | 818-591-9081
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Provider Business Mailing Address
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Address Line | 22287 MULHOLLAND HWY # 396
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City | CALABASAS
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State | CA
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Zip | 91302-5157
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Country | US
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Telephone | 424-333-0107
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Fax | 818-591-9081
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW19650
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License Number State | CA
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