Provider Demographics
NPI:1366836967
Name:EINERSON, LUKE (PHD, LMFT, RH)
Entity Type:Individual
Prefix:MR
First Name:LUKE
Middle Name:
Last Name:EINERSON
Suffix:
Gender:M
Credentials:PHD, LMFT, RH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-2017
Mailing Address - Country:US
Mailing Address - Phone:208-357-3104
Mailing Address - Fax:888-990-2826
Practice Address - Street 1:101 E MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-2017
Practice Address - Country:US
Practice Address - Phone:208-357-3104
Practice Address - Fax:888-990-2826
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5636106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist