Lucas Blair, LSW, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2304670 Issued in OH

Practice address

36 N Detroit St
Xenia, OH 45385-2909

Phone

(937) 610-4673

Fax

(937) 736-2615

NPI assigned

Sep 17, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Decoach Team LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  Medicare reassignment
• Decoach Team LLC

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1033545520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628",
            "fax_number": "513-737-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N DETROIT ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852909",
            "telephone_number": "937-610-4673",
            "fax_number": "937-736-2615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "452 W Market St",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453852815",
            "country_code": "US",
            "telephone_number": "937-376-8700",
            "fax_number": "937-376-8725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2317 E Home Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455032520",
            "country_code": "US",
            "telephone_number": "937-390-8060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2611 Wayne Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454201833",
            "country_code": "US",
            "telephone_number": "937-228-0579 x7703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "LUCAS",
        "credential": "LSW, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162201",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1802360",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0293846",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosalie Barath Beverly, M.D.
• Rebecca Sue Bickett, LPN
• Emma Biermann
• Alexandria Bilbrey
• Patricia Ann Binkis, RN
• Dora Suella Blevins
• Jacqueline Elaine Blevins
• Alvin Bloomer
• Gary Boddie
• Brett Matthew Bodmer

• Clinical Social Worker in Xenia, OH
• Providers in Xenia, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.