Provider Demographics
NPI:1326672502
Name:COMPLETE THERAPEUTIC SOLUTIONS
Entity Type:Organization
Organization Name:COMPLETE THERAPEUTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:540-207-1108
Mailing Address - Street 1:5104 GREENWICH MEWS
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8515
Mailing Address - Country:US
Mailing Address - Phone:540-207-1108
Mailing Address - Fax:
Practice Address - Street 1:4451 LONGHILL RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1534
Practice Address - Country:US
Practice Address - Phone:540-207-1108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty