Individual
CAROL V LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6451 MCCALL ST # D, BONNERS FERRY, ID 83805-8525
(208) 267-2070
Mailing address
PO BOX 1654, BONNERS FERRY, ID 83805-1654
(208) 267-5050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-31519
ID
104100000X
Social Worker
LMSW26879
ID
Other
Enumeration date
01/08/2008
Last updated
05/19/2020
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