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NPI Code Detail

MEDICARE: LAURA KATHERINE LUCHT LMSW

MEDICARE: LAURA KATHERINE LUCHT LMSW
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
1101Y00000XCounselor6801091120MI
2104100000XSocial Worker6801091120MI
31041C0700XClinical Social Worker6801091120MI

General Provider Information

NPI Number : 1194956656
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA KATHERINE LUCHT LMSW
Provider Business Mailing Address
First Line : 2100 N MAIN ST STE 304
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-1877
Country : US
Telephone Number : 574-546-1900
Fax Number : 574-546-1999
Provider Business Practice Location Address
First Line : 3200 GREENFIELD RD STE 300
Second Line :
City : DEARBORN
State : MI
Zip : 48120-1805
Country : US
Telephone Number : 574-546-1900
Fax Number : 574-546-1999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2009
Last Update Date : 11/20/2024

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Directions to “ LAURA KATHERINE LUCHT LMSW” Practice Location

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