MEDICARE: DR. TERRI KAY LUCAS PH.D., LCPC

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
1	101YP2500X	Professional Counselor	LC5897	MD

General Provider Information

NPI Number	:	1346633237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRI KAY LUCAS PH.D., LCPC

Provider Business Mailing Address
First Line	:	PO BOX 3108
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-2118
Country	:	US
Telephone Number	:	240-682-2719
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 DUKE ST STE 202
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-6128
Country	:	US
Telephone Number	:	240-682-2719
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2015
Last Update Date	:	03/17/2015

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