Provider Demographics
NPI:1356782726
Name:LUKAS, CHRISTINA JEAN (MT, LLPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:JEAN
Last Name:LUKAS
Suffix:
Gender:F
Credentials:MT, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 OAKDALE DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-4229
Mailing Address - Country:US
Mailing Address - Phone:231-944-4745
Mailing Address - Fax:
Practice Address - Street 1:3879 M 72 E
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MI
Practice Address - Zip Code:49690-9359
Practice Address - Country:US
Practice Address - Phone:231-348-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist