=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659879690
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOLLESTON LUKE COUNSELING LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2018
-----------------------------------------------------
Last Update Date | 10/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 615 E PIONEER STE 213
-----------------------------------------------------
City | PUYALLUP
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98372-3320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-330-7204
-----------------------------------------------------
Fax | 253-387-8151
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5114 POINT FOSDICK DR STE F #220
-----------------------------------------------------
City | GIG HARBOR
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-330-7204
-----------------------------------------------------
Fax | 253-387-8151
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. ALEXANDRA EVE MOLLESTON LUKE
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 253-224-3432
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------