MEDICARE: TILWANJA 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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1427916329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TILWANJA LUCAS

Provider Business Mailing Address
First Line	:	122 W FORSYTH ST
Second Line	:
City	:	AMERICUS
State	:	GA
Zip	:	31709-3561
Country	:	US
Telephone Number	:	229-591-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 GA HIGHWAY 96 STE A
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-2587
Country	:	US
Telephone Number	:	229-591-4000
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ TILWANJA LUCAS ” Practice Location

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