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General NPI Number Information
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NPI Number | 1114468535
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Entity Type | Organization
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Legal Business Name | LUCAS COUNSELING, PLLC
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 6030 BENNETTSVILLE LN APARTMENT 302
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City | CHARLOTTE
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State | NC
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Zip | 28262-2387
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Country | US
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Telephone | 248-880-2964
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Fax | 855-622-0417
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Provider Business Mailing Address
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Address Line | 301 MCCULLOUGH DR SUITE 400
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City | CHARLOTTE
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State | NC
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Zip | 28262-3310
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Country | US
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Telephone | 248-880-2964
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Fax | 855-622-0417
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | NICOLE SANGSTER-LUCAS
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Credential | LCSW
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Telephone | 248-880-2964
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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 | C009728
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License Number State | NC
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