Provider Demographics
NPI:1154122596
Name:LUCKY, MORRIS G (LSW)
Entity type:Individual
Prefix:
First Name:MORRIS
Middle Name:G
Last Name:LUCKY
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 POPLAR RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5242
Mailing Address - Country:US
Mailing Address - Phone:908-581-4536
Mailing Address - Fax:
Practice Address - Street 1:615 HOPE RD BLDG 5B2ND
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1277
Practice Address - Country:US
Practice Address - Phone:732-389-0697
Practice Address - Fax:732-389-0611
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05609500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker