MEDICARE: LUKE O'KEEFE RYAN LPC

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	101YM0800X	Mental Health Counselor	LPC-24441	AZ

General Provider Information

NPI Number	:	1760181614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE O'KEEFE RYAN LPC

Provider Business Mailing Address
First Line	:	1500 N PRIEST DR
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85288-1213
Country	:	US
Telephone Number	:	833-719-0886
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 E BROADWAY BLVD STE 200
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-5341
Country	:	US
Telephone Number	:	520-305-9735
Fax Number	:

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

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	06/20/2026

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