Provider Demographics
NPI:1386246726
Name:LUCEY, ASHLEY ANN
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ANN
Last Name:LUCEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 GLEN EASTON RD
Mailing Address - Street 2:
Mailing Address - City:GLEN EASTON
Mailing Address - State:WV
Mailing Address - Zip Code:26039-1438
Mailing Address - Country:US
Mailing Address - Phone:304-280-3378
Mailing Address - Fax:
Practice Address - Street 1:732 GLEN EASTON RD
Practice Address - Street 2:
Practice Address - City:GLEN EASTON
Practice Address - State:WV
Practice Address - Zip Code:26039-1438
Practice Address - Country:US
Practice Address - Phone:304-280-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator