Provider Demographics
NPI:1225530876
Name:MAIER, LUKAS (PSYD)
Entity Type:Individual
Prefix:
First Name:LUKAS
Middle Name:
Last Name:MAIER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 POLIFKA DR BLDG 1042
Mailing Address - Street 2:
Mailing Address - City:SHAW AFB
Mailing Address - State:SC
Mailing Address - Zip Code:29152-5100
Mailing Address - Country:US
Mailing Address - Phone:803-895-6199
Mailing Address - Fax:
Practice Address - Street 1:US MEDICAL CLINIC, BUILDING 208
Practice Address - Street 2:
Practice Address - City:GEILENKIRCHEN
Practice Address - State:NRW
Practice Address - Zip Code:52511
Practice Address - Country:DE
Practice Address - Phone:314-458-3378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
WAPY60909669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist