Individual
CANDACE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
477 VILLAGE SQUARE CT, STONE MOUNTAIN, GA 30083-4274
(251) 554-1092
(404) 465-3650
Mailing address
477 VILLAGE SQUARE CT, STONE MOUNTAIN, GA 30083-4274
(251) 554-1092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
—
—
225800000X
Recreation Therapist
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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