Provider Demographics
NPI:1588268502
Name:NOVARIO, LUCY (LPC)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:
Last Name:NOVARIO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63143-4217
Mailing Address - Country:US
Mailing Address - Phone:815-488-7240
Mailing Address - Fax:
Practice Address - Street 1:3508 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MO
Practice Address - Zip Code:63143-4217
Practice Address - Country:US
Practice Address - Phone:815-488-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017001485101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor