Provider Demographics
NPI:1457631970
Name:LUKE, CHRISTINA JEAN (LPCA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JEAN
Last Name:LUKE
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 WATERFORD TIDE LOOP APT 2931
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8618
Mailing Address - Country:US
Mailing Address - Phone:704-890-8237
Mailing Address - Fax:
Practice Address - Street 1:8000 WATERFORD TIDE LOOP APT 2931
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8618
Practice Address - Country:US
Practice Address - Phone:704-890-8237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health