Provider Demographics
NPI:1992108211
Name:MOONS, JAMES LUCAS (LPCC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LUCAS
Last Name:MOONS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:LUCAS
Other - Last Name:MOONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:270-858-6655
Mailing Address - Fax:270-858-4027
Practice Address - Street 1:CUMBERLAND COUNTY ELEMENTARY HEALTHY KIDS CLINIC
Practice Address - Street 2:150 GLASGOW RD
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717-9695
Practice Address - Country:US
Practice Address - Phone:844-435-0900
Practice Address - Fax:270-858-4027
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KY176407101YP2500X
KY175407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health