=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942153689
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LLC MARK LUCAS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2026
-----------------------------------------------------
Last Update Date | 02/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30 CONGRESS ST STE 101
-----------------------------------------------------
City | SAINT ALBANS
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05478-1745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-730-3383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 253
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05441-0253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-730-3383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / CLINICIAN
-----------------------------------------------------
Name | MARK LUCAS
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 802-730-3383
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------