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NPI Code Detail

MEDICARE: LUKE ROY ALLEN PHD

MEDICARE:   LUKE ROY ALLEN  PHD
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
1103TC1900XCounseling PsychologistPY1030NV
2103TC1900XCounseling Psychologist3473OR

General Provider Information

NPI Number : 1033623194
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE ROY ALLEN PHD
Provider Business Mailing Address
First Line : 1050 E FLAMINGO ROAD
Second Line : S107 1456
City : LAS VEGAS
State : NV
Zip : 89119-1435
Country : US
Telephone Number : 702-530-6134
Fax Number : 725-269-1561
Provider Business Practice Location Address
First Line : 4950 S RAINBOW BLVD #150 #3008
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1435
Country : US
Telephone Number : 702-530-6134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2017
Last Update Date : 04/19/2023

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