Provider Demographics
NPI:1861721706
Name:HILLERY-LUCAS, NANCY (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HILLERY-LUCAS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N WASHINGTON ST
Mailing Address - Street 2:SUITE 2470
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-1216
Mailing Address - Country:US
Mailing Address - Phone:315-867-1465
Mailing Address - Fax:315-867-1469
Practice Address - Street 1:301 N WASHINGTON ST
Practice Address - Street 2:SUITE 2470
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1216
Practice Address - Country:US
Practice Address - Phone:315-867-1465
Practice Address - Fax:315-867-1469
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP720611041C0700X
NYR080567-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP72061OtherLIMITED PERMIT MASTER SOCIAL WORKER