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NPI 1093999310

NPI 1093999310 : AMANDA L. LUCAS LCSW : NASHVILLE, TN

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General NPI Number Information
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    NPI Number           |    1093999310
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA L. LUCAS LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/21/2007
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    Last Update Date     |    11/20/2019
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Provider Practice Location Address
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    Address Line         |    754 LYNWOOD AVE 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37203-5030
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    Country              |    US
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    Telephone            |    615-498-0241
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    Fax                  |    615-369-3025
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Provider Business Mailing Address
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    Address Line         |    754 LYNWOOD AVE 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37203-5030
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    Country              |    US
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    Telephone            |    615-498-0241
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    Fax                  |    615-298-3011
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    4877
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    License Number State |    TN
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