Provider Demographics
NPI:1003861956
Name:LUKE, DOROTHY CHRISTIN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:CHRISTIN
Last Name:LUKE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 TADLOCK PL
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5523
Mailing Address - Country:US
Mailing Address - Phone:704-576-3635
Mailing Address - Fax:704-377-4147
Practice Address - Street 1:2132 MCCLINTOCK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-5114
Practice Address - Country:US
Practice Address - Phone:704-576-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002779Medicaid
NC135EJOtherBLUE CROSS BLUE SHIELD