Healthcare Provider Details

I. General information

NPI: 1346587458
Provider Name (Legal Business Name): LUCAS C ESCH MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6065 STONEY CREEK DR
FORT WAYNE IN
46825-4411
US

IV. Provider business mailing address

6065 STONEY CREEK DR
FORT WAYNE IN
46825-4411
US

V. Phone/Fax

Practice location:
  • Phone: 260-600-9546
  • Fax:
Mailing address:
  • Phone: 260-600-9546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number99132712A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: