1568604635 NPI number — MRS. CHERYL LYNN LUCAS LPC, NCC, CAC

Table of content: DAYLA J MILLER SLP (NPI 1144062845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568604635 NPI number — MRS. CHERYL LYNN LUCAS LPC, NCC, CAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUCAS
Provider First Name:
CHERYL
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, NCC, CAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568604635
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CEDAR RIDGE DR
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15205-9691
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-921-7000
Provider Business Mailing Address Fax Number:
412-921-7260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 CEDAR RIDGE DR
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15205-9691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-921-7000
Provider Business Practice Location Address Fax Number:
412-921-7260
Provider Enumeration Date:
04/03/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  PC002235 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: 3042 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)