Provider Demographics
NPI:1487987970
Name:MONROE, LUCAS EDWARD (LMSW)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:EDWARD
Last Name:MONROE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FLANDERS LN
Mailing Address - Street 2:
Mailing Address - City:WEST HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12491-5612
Mailing Address - Country:US
Mailing Address - Phone:518-321-5115
Mailing Address - Fax:
Practice Address - Street 1:59 GREEN ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4473
Practice Address - Country:US
Practice Address - Phone:518-321-5115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0800021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical