MEDICARE: DOROTHY CHRISTIN LUKE MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C004450	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	135EJ	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1003861956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY CHRISTIN LUKE MSW, LCSW

Provider Business Mailing Address
First Line	:	809 TADLOCK PL
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-5523
Country	:	US
Telephone Number	:	704-576-3635
Fax Number	:	704-377-4147

Provider Business Practice Location Address
First Line	:	2132 MCCLINTOCK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-5114
Country	:	US
Telephone Number	:	704-576-3635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	09/04/2007

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