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General NPI Number Information
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NPI Number | 1205100476
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Entity Type | Individual
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Provider Name | LUCAS D ABERNATHY MA, LMHC
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Gender | Male
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 614 W MCGRAW ST
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City | SEATTLE
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State | WA
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Zip | 98119-2888
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Country | US
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Telephone | 206-713-9168
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Fax |
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Provider Business Mailing Address
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Address Line | 4223 N 26TH ST
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City | TACOMA
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State | WA
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Zip | 98407-5208
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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 | LH60648982
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License Number State | WA
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