Provider Demographics
NPI:1619849189
Name:LUCAS, DEBORAH ANN (LMSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RATTLESNAKE RUN
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:NM
Mailing Address - Zip Code:87015-8791
Mailing Address - Country:US
Mailing Address - Phone:505-573-1482
Mailing Address - Fax:
Practice Address - Street 1:7 RATTLESNAKE RUN
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-8791
Practice Address - Country:US
Practice Address - Phone:505-573-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-09491104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty