Healthcare Provider Details

I. General information

NPI: 1770686024
Provider Name (Legal Business Name): INGE LUECHINGER FAMILY THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 CHECHERO ST STE 2
CLAYTON GA
30525-6181
US

IV. Provider business mailing address

1269 PARKER RD SE
CONYERS GA
30094-5957
US

V. Phone/Fax

Practice location:
  • Phone: 678-438-4233
  • Fax: 770-761-9070
Mailing address:
  • Phone: 678-438-4233
  • Fax: 770-761-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN079843 CNS/PMH
License Number StateGA

VIII. Authorized Official

Name: MRS. INGE C LUECHINGER
Title or Position: PRESIDENT
Credential: CNS PMH
Phone: 678-438-4233