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NPI Code Detail

MEDICARE: MR. THOMAS CHARLES LUCAS M.ED., LPC

MEDICARE: MR. THOMAS CHARLES LUCAS M.ED., LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4599CO

General Provider Information

NPI Number : 1295959484
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS CHARLES LUCAS M.ED., LPC
Provider Business Mailing Address
First Line : 2921 CHAMPA ST
Second Line : APT B
City : DENVER
State : CO
Zip : 80205-2789
Country : US
Telephone Number : 201-264-4408
Fax Number :
Provider Business Practice Location Address
First Line : 2100 N BROADWAY
Second Line :
City : DENVER
State : CO
Zip : 80205-2526
Country : US
Telephone Number : 201-264-4408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 03/25/2016

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