Provider Demographics
NPI:1538436902
Name:LUCAS, CARRIE ANNE (MS, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MS, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 SWEET AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-3538
Mailing Address - Country:US
Mailing Address - Phone:479-650-9239
Mailing Address - Fax:
Practice Address - Street 1:5401 ROGERS AVE STE 200
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3763
Practice Address - Country:US
Practice Address - Phone:479-235-4658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1111117101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor