Basic Information
| Provider Information | |||||||||
| NPI: | 1497295687 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENGLISH | ||||||||
| FirstName: | LUCAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 680 AMERICAN AVE | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | KING OF PRUSSIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194064023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106446464 | ||||||||
| FaxNumber: | 6109816078 | ||||||||
| Practice Location | |||||||||
| Address1: | 1440 RUSSELL RD | ||||||||
| Address2: | |||||||||
| City: | PAOLI | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193011236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106446464 | ||||||||
| FaxNumber: | 6109816078 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2017 | ||||||||
| LastUpdateDate: | 03/07/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SW132028 | PA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.