Individual
TIFFANY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
203A FAIRGROUNDS RD, HARDINSBURG, KY 40143-2585
(270) 580-7253
(270) 580-7290
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3229
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11574923
CAQH
—
Enumeration date
05/22/2006
Last updated
01/10/2019
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