Healthcare Provider Details

I. General information

NPI: 1013002302
Provider Name (Legal Business Name): FRANK PAUL LUKASAVAGE MSW,LISW, LICSW, LAD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUN RISE COUNSELING SERVICES NM LLC 1945 OLD US66 UNIT B
EDGEWOOD NM
87015
US

IV. Provider business mailing address

SUN RISE COUNSELING SERVICES NM LLC PO BOX 3566
MORIARTY NM
87035-3566
US

V. Phone/Fax

Practice location:
  • Phone: 505-835-3276
  • Fax: 505-835-3276
Mailing address:
  • Phone: 505-835-3276
  • Fax: 505-835-3276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2081
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3831
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: