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NPI Code Detail

MEDICARE: EDWARD EMILE LUCAS III LCSW

MEDICARE: EDWARD EMILE LUCAS III LCSW
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
11041C0700XClinical Social Worker1092LA

General Provider Information

NPI Number : 1508913922
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD EMILE LUCAS III LCSW
Provider Business Mailing Address
First Line : 9229 BLUEBONNET BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-2808
Country : US
Telephone Number : 225-769-7575
Fax Number : 225-769-4795
Provider Business Practice Location Address
First Line : 9229 BLUEBONNET BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-2808
Country : US
Telephone Number : 225-769-7575
Fax Number : 225-769-4795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 07/08/2007

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Directions to “ EDWARD EMILE LUCAS III LCSW” Practice Location

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