Provider Demographics
NPI:1518782622
Name:LUCAS, KELCEY RASE (LPC)
Entity type:Individual
Prefix:
First Name:KELCEY
Middle Name:RASE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2645
Mailing Address - Country:US
Mailing Address - Phone:609-320-2709
Mailing Address - Fax:
Practice Address - Street 1:457 HADDONFIELD RD STE 230B
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2220
Practice Address - Country:US
Practice Address - Phone:732-978-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01038900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional