Healthcare Provider Details
I. General information
NPI: 1750245718
Provider Name (Legal Business Name): LUECK FAMILY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
828 GREENE ST
AUGUSTA GA
30901-0214
US
IV. Provider business mailing address
2450 RIVERLOOK DR
AUGUSTA GA
30904-3375
US
V. Phone/Fax
- Phone: 706-204-9544
- Fax:
- Phone: 706-203-9544
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MORGAN
LUECK
Title or Position: OWNER
Credential: LMFT
Phone: 615-202-4016