Provider Demographics
NPI:1972502821
Name:LUKSE, MICHELLE PRINCE (LPC, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:PRINCE
Last Name:LUKSE
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10818 KENDERLY CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2122
Mailing Address - Country:US
Mailing Address - Phone:704-542-6565
Mailing Address - Fax:
Practice Address - Street 1:4401 COLWICK RD
Practice Address - Street 2:SUITE 705
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2349
Practice Address - Country:US
Practice Address - Phone:704-362-0099
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC LPC 964101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor