Provider Demographics
NPI:1053344614
Name:LUCHT, EVA REGINA (LCPC)
Entity type:Individual
Prefix:MS
First Name:EVA
Middle Name:REGINA
Last Name:LUCHT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MANDA DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7852
Mailing Address - Country:US
Mailing Address - Phone:240-385-3030
Mailing Address - Fax:240-380-2301
Practice Address - Street 1:108 MANDA DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:MD
Practice Address - Zip Code:21769-7852
Practice Address - Country:US
Practice Address - Phone:240-385-3030
Practice Address - Fax:240-380-2301
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1750101YM0800X
IL180.009062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health