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Individual

LUCAS BARAJAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21275 STICK ROSS MOUNTAIN RD, TAHLEQUAH, OK 74464-7343
(918) 316-1309
Mailing address
21761 S 523 RD LOT 20, PARK HILL, OK 74451-4209

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
175T00000X
Peer Specialist
Primary
OK

Other

Enumeration date
04/07/2026
Last updated
05/26/2026
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