Provider Demographics
NPI:1548790181
Name:LUCE, CARLI (LMSW)
Entity Type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:LUCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CARLI
Other - Middle Name:
Other - Last Name:NUECHTERLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:520 BUTTERNUT DR STE 8204
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1587
Mailing Address - Country:US
Mailing Address - Phone:248-787-6777
Mailing Address - Fax:
Practice Address - Street 1:440 S STATE ST STE 320
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2250
Practice Address - Country:US
Practice Address - Phone:248-787-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010878711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty