Provider Demographics
NPI:1467578526
Name:LUKOMSKI, TERRI FRANCES (LMSW, CTRS)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:FRANCES
Last Name:LUKOMSKI
Suffix:
Gender:F
Credentials:LMSW, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S MAIN ST STE 100-602
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1642
Mailing Address - Country:US
Mailing Address - Phone:323-350-2556
Mailing Address - Fax:
Practice Address - Street 1:1219 MEADOW LN
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1313
Practice Address - Country:US
Practice Address - Phone:323-350-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225800000X225800000X
MI68010939541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist