Healthcare Provider Details

I. General information

NPI: 1215868237
Provider Name (Legal Business Name): KASHA LUCKNER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 1ST ST N STE 240
WICHITA KS
67202-2740
US

IV. Provider business mailing address

800 E 1ST ST N STE 240
WICHITA KS
67202-2740
US

V. Phone/Fax

Practice location:
  • Phone: 316-202-8391
  • Fax:
Mailing address:
  • Phone: 316-519-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05423
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: