Provider Demographics
NPI:1306647938
Name:LUCENT PSYCH PLLC
Entity type:Organization
Organization Name:LUCENT PSYCH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANCER LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC, LMSW
Authorized Official - Phone:713-505-2770
Mailing Address - Street 1:522 W RIVERSIDE AVE STE N
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0581
Mailing Address - Country:US
Mailing Address - Phone:509-596-1434
Mailing Address - Fax:
Practice Address - Street 1:450 ALASKAN WAY S STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2785
Practice Address - Country:US
Practice Address - Phone:509-596-1434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)