| Carmen L. Lucia Psyd Llc | |
|
15215 S 48th St Ste 154 Phoenix AZ 85044-9139 | |
| (480) 980-7355 | |
| (480) 718-8762 |
| Full Name | Carmen L. Lucia Psyd Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15215 S 48th St Ste 154, Phoenix, Arizona |
| Authorized Official Name and Position | Carmen Lynne Lucia (OWNER) |
| Authorized Official Contact | 4809807355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carmen L. Lucia Psyd Llc 15215 S 48th St Ste 154 Phoenix AZ 85044-9139 Ph: (480) 980-7355 | Carmen L. Lucia Psyd Llc 15215 S 48th St Ste 154 Phoenix AZ 85044-9139 Ph: (480) 980-7355 |
| NPI Number | 1164036935 |
|---|---|
| Provider Enumeration Date | 08/31/2020 |
| Last Update Date | 09/15/2020 |
| Certification Date | 09/15/2020 |
| Medicare PECOS PAC ID | 5698187805 |
|---|---|
| Medicare Enrollment ID | O20201211002460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164036935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carmen L Lucia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841599941 PECOS PAC ID: 0446569081 Enrollment ID: I20151021000985 |
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