Provider Demographics
NPI:1952967713
Name:HASSEVOORT, LUKE (LMSW)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:HASSEVOORT
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 VICTOR ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48203-3127
Mailing Address - Country:US
Mailing Address - Phone:313-252-1950
Mailing Address - Fax:
Practice Address - Street 1:77 VICTOR ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:MI
Practice Address - Zip Code:48203-3127
Practice Address - Country:US
Practice Address - Phone:313-252-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010983461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical