Provider Demographics
NPI:1043509276
Name:LUKE, KATHLEEN (MA COUNSELING)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:LUKE
Suffix:
Gender:F
Credentials:MA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-5011
Mailing Address - Country:US
Mailing Address - Phone:207-799-4927
Mailing Address - Fax:
Practice Address - Street 1:42 CLIFF AVE
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-5011
Practice Address - Country:US
Practice Address - Phone:207-799-4927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor