Provider Demographics
NPI:1538624655
Name:LUCIER, ERIC ALAN (LCMHC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ALAN
Last Name:LUCIER
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:BEEBE PLAIN
Mailing Address - State:VT
Mailing Address - Zip Code:05823-0066
Mailing Address - Country:US
Mailing Address - Phone:802-505-5803
Mailing Address - Fax:
Practice Address - Street 1:209 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-5534
Practice Address - Country:US
Practice Address - Phone:802-334-7921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health