Provider Demographics
NPI:1437746583
Name:SAMMONS, LUTHER DANIEL (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:LUTHER
Middle Name:DANIEL
Last Name:SAMMONS
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1736
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75663-1736
Mailing Address - Country:US
Mailing Address - Phone:903-941-9353
Mailing Address - Fax:
Practice Address - Street 1:464 HOLLYBROOK ST
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-2074
Practice Address - Country:US
Practice Address - Phone:903-941-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional