Provider Demographics
NPI:1053940643
Name:MOREHEAD, LUKE (LPCA)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:MOREHEAD
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-5074
Mailing Address - Country:US
Mailing Address - Phone:606-928-5116
Mailing Address - Fax:606-928-5547
Practice Address - Street 1:5900 ROUTE US 60 W
Practice Address - Street 2:SUITE B
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102
Practice Address - Country:US
Practice Address - Phone:606-939-8756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261972101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY261972OtherLICENSE PROFESSIONAL COUNSELOR ASSOCIATE