Provider Demographics
NPI:1134804222
Name:FINNELL, LUCAS ANTHONY
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:ANTHONY
Last Name:FINNELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 WHEATLAND CIR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1123
Mailing Address - Country:US
Mailing Address - Phone:310-991-2873
Mailing Address - Fax:
Practice Address - Street 1:225 W PIKE ST
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1188
Practice Address - Country:US
Practice Address - Phone:724-503-6670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF0011468106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist