Provider Demographics
NPI:1215504253
Name:STAMPS, LUCIAN B (PHD)
Entity type:Individual
Prefix:DR
First Name:LUCIAN
Middle Name:B
Last Name:STAMPS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 MANHATTAN BLVD STE J-259
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-7300
Mailing Address - Country:US
Mailing Address - Phone:504-638-5392
Mailing Address - Fax:
Practice Address - Street 1:1801 MANHATTAN BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-7300
Practice Address - Country:US
Practice Address - Phone:504-638-5392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6667101Y00000X, 101YP2500X
LA458459101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool