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General NPI Number Information
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NPI Number | 1427781699
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Entity Type | Individual
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Provider Name | STEPHANIE LUCKIE
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Gender | Female
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 700 S JAMES H MCGEE BLVD
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City | DAYTON
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State | OH
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Zip | 45402-8055
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Country | US
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Telephone | 937-226-1584
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 BETHUNE CIR
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City | DAYTON
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State | OH
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Zip | 45417-4416
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Country | US
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Telephone | 937-759-7527
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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Taxonomy #4
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Taxonomy Code | 102X00000X
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Taxonomy Name | Poetry Therapist
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License Number |
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Taxonomy #5
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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