Provider Demographics
NPI:1184190233
Name:LUCHANSKY PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:LUCHANSKY PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCHANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:570-954-6961
Mailing Address - Street 1:395 BEDFORD ST STE C
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1801
Mailing Address - Country:US
Mailing Address - Phone:570-954-6961
Mailing Address - Fax:570-319-9674
Practice Address - Street 1:395 BEDFORD ST STE C
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1801
Practice Address - Country:US
Practice Address - Phone:570-954-6961
Practice Address - Fax:570-319-9674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty