Provider Demographics
NPI:1841765476
Name:LUKOWIAK, STACEY (LCSW, LCAD,CCS)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:
Last Name:LUKOWIAK
Suffix:
Gender:F
Credentials:LCSW, LCAD,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 BARBARA DR
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1129
Mailing Address - Country:US
Mailing Address - Phone:973-493-9221
Mailing Address - Fax:
Practice Address - Street 1:88 BARBARA DR
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1129
Practice Address - Country:US
Practice Address - Phone:973-493-9221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05803600104100000X
NJ37LC00263000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)