Provider Demographics
NPI:1700064375
Name:VICTORIA F LUCKING PLLC LCSW
Entity Type:Organization
Organization Name:VICTORIA F LUCKING PLLC LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:FRANCINE
Authorized Official - Last Name:LUCKING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-740-9821
Mailing Address - Street 1:4612 GROUNDNUT CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613
Mailing Address - Country:US
Mailing Address - Phone:919-740-9821
Mailing Address - Fax:
Practice Address - Street 1:2920 HIGHWOODS BLVD
Practice Address - Street 2:SUITE 127
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604
Practice Address - Country:US
Practice Address - Phone:919-872-5220
Practice Address - Fax:919-872-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0036731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty