Basic Information
| Provider Information | |||||||||
| NPI: | 1619699824 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANI LUKENS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 HANCOCK ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010603310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107816169 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11 HANCOCK ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | NORTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010603310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8023919118 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2022 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | LUKENS | ||||||||
| AuthorizedOfficialFirstName: | DANIELLE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6107816169 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.