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General NPI Number Information
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NPI Number | 1588910608
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Entity Type | Individual
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Provider Name | NICOLE D SANGSTER LUCAS MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 11/08/2016
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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 |
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Provider Business Mailing Address
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Address Line | 6030 BENNETTSVILLE LANE APARTMENT 302
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City | CHARLOTTE
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State | NC
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Zip | 28262
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Country | US
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Telephone | 248-880-2964
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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 | 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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