Provider Demographics
NPI:1952420192
Name:LUKOFF, SHELLY R (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:R
Last Name:LUKOFF
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 MARLTON PIKE E
Mailing Address - Street 2:SUITE L-5
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1825
Mailing Address - Country:US
Mailing Address - Phone:856-424-0112
Mailing Address - Fax:856-751-3849
Practice Address - Street 1:1999 MARLTON PIKE E
Practice Address - Street 2:SUITE L-5
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1825
Practice Address - Country:US
Practice Address - Phone:856-424-0112
Practice Address - Fax:856-751-3849
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000181001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical