Provider Demographics
NPI:1790958767
Name:LUKE, CARRIE ANN (ADCA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:LUKE
Suffix:
Gender:F
Credentials:ADCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:66 PEARL ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4165
Mailing Address - Country:US
Mailing Address - Phone:207-773-9931
Mailing Address - Fax:207-879-5576
Practice Address - Street 1:66 PEARL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4165
Practice Address - Country:US
Practice Address - Phone:207-773-9931
Practice Address - Fax:207-879-5576
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAD4186101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)