Basic Information
| Provider Information | |||||||||
| NPI: | 1811581507 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUCAS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LGSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 20TH ST | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257031850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046968700 | ||||||||
| FaxNumber: | 3046968701 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 20TH ST | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257031850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046968700 | ||||||||
| FaxNumber: | 3046968701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2021 | ||||||||
| LastUpdateDate: | 11/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | BP00945678 | WV | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.