Provider Demographics
NPI:1922273374
Name:LUKE, HENRY (MSW: LCSW;LMSW)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:LUKE
Suffix:
Gender:M
Credentials:MSW: LCSW;LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8717 KEPHART LN
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1444
Mailing Address - Country:US
Mailing Address - Phone:269-473-5200
Mailing Address - Fax:
Practice Address - Street 1:8717 KEPHART LN
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1444
Practice Address - Country:US
Practice Address - Phone:269-473-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801090064101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health