Provider Demographics
NPI:1013002302
Name:LUKASAVAGE, FRANK PAUL (MSW,LISW, LICSW, LAD)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:PAUL
Last Name:LUKASAVAGE
Suffix:
Gender:
Credentials:MSW,LISW, LICSW, LAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUN RISE COUNSELING SERVICES LLC
Mailing Address - Street 2:PO BOX 3566
Mailing Address - City:MORIARTY
Mailing Address - State:NM
Mailing Address - Zip Code:87035-3566
Mailing Address - Country:US
Mailing Address - Phone:505-891-1001
Mailing Address - Fax:
Practice Address - Street 1:SUN RISE COUNSELING SERVICES LLC
Practice Address - Street 2:5 HWY 344
Practice Address - City:STANLEY
Practice Address - State:NM
Practice Address - Zip Code:87015
Practice Address - Country:US
Practice Address - Phone:505-891-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3831101YA0400X
NM20811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM100343Medicaid
NM201012186OtherPRESBYTERIAN BEHAVIORAL H