Provider Information for 1154869212
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
AUSTIN DAVID LUCAS LCSW
Sex: Male
NPI: 1154869212
Last Updated: 2023-09-11
Certification Date: 2023-09-11
Certification Date: 2023-09-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1154869212 | ||||||||||||
| Enumeration Date | 2017-02-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1117 N 8TH ST MANITOWOC, WI 54220-2817 United States Phone: 906-239-0219 | Fax: | ||||||||||||
| Primary Practice Address | 926 SOUTH 8TH STREET MANITOWOC, WI 54221-1177 United States Phone: 920-683-4230 | Fax:920-683-4908 | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|