Healthcare Provider Details

I. General information

NPI: 1467578526
Provider Name (Legal Business Name): TERRI FRANCES LUKOMSKI LMSW, CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 MEADOW LN
CHELSEA MI
48118-1313
US

IV. Provider business mailing address

1101 S MAIN ST STE 100-602
CHELSEA MI
48118-1642
US

V. Phone/Fax

Practice location:
  • Phone: 323-350-2556
  • Fax:
Mailing address:
  • Phone: 323-350-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number225800000X
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801093954
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: