Provider Demographics
NPI:1588910608
Name:SANGSTER LUCAS, NICOLE D (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:D
Last Name:SANGSTER LUCAS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 BENNETTSVILLE LANE
Mailing Address - Street 2:APARTMENT 302
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:248-880-2964
Mailing Address - Fax:
Practice Address - Street 1:6030 BENNETTSVILLE LN
Practice Address - Street 2:APARTMENT 302
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2387
Practice Address - Country:US
Practice Address - Phone:248-880-2964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0097281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical