Provider Demographics
NPI:1013600303
Name:KATUIN, LUKE
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:KATUIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E 5TH ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1981
Mailing Address - Country:US
Mailing Address - Phone:515-216-0085
Mailing Address - Fax:
Practice Address - Street 1:309 E 5TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1974
Practice Address - Country:US
Practice Address - Phone:515-216-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA119081104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker