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NPI Code Detail

MEDICARE: MISS WHITNEY LUFFMAN SUKONICK MA, LPA, BCBA

MEDICARE: MISS WHITNEY LUFFMAN SUKONICK MA, LPA, BCBA
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
1103K00000XBehavior Analyst11212385MD
2103T00000XPsychologist4599NC

General Provider Information

NPI Number : 1417292624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS WHITNEY LUFFMAN SUKONICK MA, LPA, BCBA
Provider Business Mailing Address
First Line : 6400 MILL CV
Second Line :
City : RALEIGH
State : NC
Zip : 27617-7622
Country : US
Telephone Number : 336-244-3826
Fax Number :
Provider Business Practice Location Address
First Line : 5121 KINGDOM WAY STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6063
Country : US
Telephone Number : 919-390-7232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2012
Last Update Date : 10/01/2020

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