Provider Demographics
NPI:1891279386
Name:LOUCKA, CLAIRE C (LMFT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:C
Last Name:LOUCKA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4301
Mailing Address - Country:US
Mailing Address - Phone:954-746-8863
Mailing Address - Fax:954-744-3696
Practice Address - Street 1:6530 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4301
Practice Address - Country:US
Practice Address - Phone:954-746-8863
Practice Address - Fax:954-744-3696
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3527106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist