Roberta Ann Lucas, MA PSYCHOLOGY, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361006317 Issued in MI

Practice address

23810 Michigan Ave Ste 202B
Dearborn, MI 48124-1830

Phone

(313) 359-3161

NPI assigned

Jan 29, 2021

Last updated

Jul 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amy J. Trabitz, PH.D., P.C.

  • Adolescent and Children Mental Health Clinic/Center
  • Dearborn, MI
  • NPI 1821327222
  NPD
• The Symmetry Group, LLC

  • Clinical Psychologist
  • Dearborn, MI
  • NPI 1568860898
  NPD (past)

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1356932677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 LEROY ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203144",
            "telephone_number": "313-359-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23810 MICHIGAN AVE STE 202B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241830",
            "telephone_number": "313-359-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MA PSYCHOLOGY, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361006317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loyal Pharmacy LLC
• Tijana Lozo
• Kathy Zhao Lu, MD
• Breanna Marie Luba
• Lillian Lucas-Jones
• Steven Mark Lucas, MD
• Laura Katherine Lucht, LMSW
• Tyler Luchtefeld, PT
• Frederick Lueder, MD
• Valerie J. Lukasik-Bozzo

• Clinical Psychologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.