Provider Demographics
NPI:1619022910
Name:LUKENDA, ELAINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:
Last Name:LUKENDA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 BAY HEAD DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-2421
Mailing Address - Country:US
Mailing Address - Phone:732-727-1392
Mailing Address - Fax:
Practice Address - Street 1:850 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4038
Practice Address - Country:US
Practice Address - Phone:732-857-6251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2012-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4292103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist