Provider Demographics
NPI:1528842309
Name:LUCAS, JAMELLIA DELORES (LCSW-C)
Entity type:Individual
Prefix:
First Name:JAMELLIA
Middle Name:DELORES
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 SECURITY BLVD STE 21
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-8419
Mailing Address - Country:US
Mailing Address - Phone:443-622-0868
Mailing Address - Fax:
Practice Address - Street 1:6901 SECURITY BLVD STE 21
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-8419
Practice Address - Country:US
Practice Address - Phone:443-622-0868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD242841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical