Provider Demographics
NPI:1649592890
Name:HERMAN H. LUCKE, PHD & ASSOCIATES
Entity type:Organization
Organization Name:HERMAN H. LUCKE, PHD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:HERIBERTO
Authorized Official - Last Name:LUCKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:816-942-9050
Mailing Address - Street 1:1010 CARONDELET DR
Mailing Address - Street 2:SUITE 412
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4859
Mailing Address - Country:US
Mailing Address - Phone:816-942-9050
Mailing Address - Fax:816-942-9002
Practice Address - Street 1:1010 CARONDELET DR
Practice Address - Street 2:SUITE 412
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4859
Practice Address - Country:US
Practice Address - Phone:816-942-9050
Practice Address - Fax:816-942-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY01499103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty