Provider Demographics
NPI:1174830921
Name:LUECK, NATALIA (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:
Last Name:LUECK
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MS
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:LA MAESTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 ASHBY ST # G101
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3246
Mailing Address - Country:US
Mailing Address - Phone:703-997-6641
Mailing Address - Fax:540-390-0002
Practice Address - Street 1:28 ASHBY ST SUITE G101
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:703-997-6641
Practice Address - Fax:540-390-0002
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004896101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional