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NPI Code Detail

MEDICARE: SARAH LUCAS

MEDICARE:   SARAH  LUCAS
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 Counselor86428TX

General Provider Information

NPI Number : 1366126989
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH LUCAS
Provider Business Mailing Address
First Line : 2404 LOU LN
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-3907
Country : US
Telephone Number : 940-636-9391
Fax Number :
Provider Business Practice Location Address
First Line : 2404 LOU LN
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-3907
Country : US
Telephone Number : 940-636-9391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2023
Last Update Date : 06/14/2023

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Directions to “ SARAH LUCAS ” Practice Location

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