Provider Demographics
NPI:1962038737
Name:PAYSON, LUKE CHARLES (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:CHARLES
Last Name:PAYSON
Suffix:
Gender:M
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1258
Mailing Address - Country:US
Mailing Address - Phone:610-984-7625
Mailing Address - Fax:
Practice Address - Street 1:112 N RICHHILL ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1308
Practice Address - Country:US
Practice Address - Phone:610-984-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional