Lucas Eberhardt de Master, PSYD, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2589 Issued in OR

Legal business name

LUCAS EBERHARDT DE MASTER, PSYD, LLC

Practice address

10201 SE Main St Ste 29
Portland, OR 97216-2937

Phone

(971) 220-5993

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Lucas Eberhardt de Master, PSYDNPI 1356776447

Title

Clinical Psychologist

Phone

(971) 220-5993

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lucas Eberhardt de Master, PSY.D.

  • Clinical Psychologist
  • Portland, OR
  • NPI 1356776447

  WA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1124538293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST STE 29",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "971-220-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST STE 29",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "971-220-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCAS EBERHARDT DE MASTER, PSYD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "EBERHARDT DE MASTER",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "971-220-5993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Lubin, LPCA
• Anne Lubischer, RPH
• Kate Luc
• Phoebe Hiu-Nam Luc, RD
• Jon Lucaj, MD
• Aiyana Lucas, LCSW
• Avery Lucas
• Carolyn Marie Lucas, M.S.
• Elizabeth Lucas
• Jennifer M. Lucas, NP

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.