Provider Demographics
NPI:1063507911
Name:LUCAS, CHRISTINA (MSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2416
Mailing Address - Country:US
Mailing Address - Phone:724-545-4540
Mailing Address - Fax:724-548-8119
Practice Address - Street 1:205B S DUFFY RD STE 2
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2708
Practice Address - Country:US
Practice Address - Phone:724-256-9881
Practice Address - Fax:724-256-9883
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0144191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000533733OtherHIGHMARK
PA289997OtherUBH
PA464677OtherVALUE OPTIONS
PA7735267OtherAETNA
PA051923Medicare ID - Type Unspecified