Provider Demographics
NPI:1518077619
Name:LUKE, JULIE SYMONS (LCSW LPC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SYMONS
Last Name:LUKE
Suffix:
Gender:F
Credentials:LCSW LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 PHELAN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6200
Mailing Address - Country:US
Mailing Address - Phone:409-860-0001
Mailing Address - Fax:409-860-0010
Practice Address - Street 1:5825 PHELAN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706
Practice Address - Country:US
Practice Address - Phone:409-860-0001
Practice Address - Fax:409-860-0010
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14580101Y00000X
TX10335LPC103T00000X
TX14580LCSW103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5761005OtherAETNA
TX11121300OtherMAGELLAN
TX112961101Medicaid
TX00S59UMedicare ID - Type Unspecified