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General NPI Number Information
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NPI Number | 1518782622
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Entity Type | Individual
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Provider Name | KELCEY RASE LUCAS LPC
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 457 HADDONFIELD RD STE 230B
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2220
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Country | US
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Telephone | 732-978-9730
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 HAMILTON DR
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City | VOORHEES
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State | NJ
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Zip | 08043-2645
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Country | US
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Telephone | 609-320-2709
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC01038900
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License Number State | NJ
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