Provider Demographics
NPI:1114205598
Name:LUCHTAN, ANA (MH)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:
Last Name:LUCHTAN
Suffix:
Gender:F
Credentials:MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21075 NE 34TH AVE
Mailing Address - Street 2:APT # 203
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3588
Mailing Address - Country:US
Mailing Address - Phone:305-466-8589
Mailing Address - Fax:
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD
Practice Address - Street 2:# 907
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4634
Practice Address - Country:US
Practice Address - Phone:561-445-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health