Provider Demographics
NPI:1649416322
Name:ELAINE LUKENDA, PSY.D. LLC
Entity Type:Organization
Organization Name:ELAINE LUKENDA, PSY.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKENDA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-857-6251
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4292103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty