Provider Demographics
NPI:1699931311
Name:LUCAS, BASIL P (LMSW)
Entity type:Individual
Prefix:MR
First Name:BASIL
Middle Name:P
Last Name:LUCAS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 N 22ND ST
Mailing Address - Street 2:#1
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-4901
Mailing Address - Country:US
Mailing Address - Phone:201-207-1165
Mailing Address - Fax:
Practice Address - Street 1:233 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4924
Practice Address - Country:US
Practice Address - Phone:718-564-2062
Practice Address - Fax:718-564-2032
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081315-1101Y00000X, 101YM0800X, 103TA0700X, 103TB0200X, 106H00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical