| Doctor Name: | SHAE NICOLE LUSTER |
| NPI Number: | 1225497365 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | MH13989 |
| Business Practice Address: | 21903 Panama City Beach Pkwy Panama City Beach, FL - 324133219 |
| Business Phone Number: | 8506281956 |
| Business Fax Number: | |
| Mailing Address: | 21903 Panama City Beach Pkwy, PANAMA CITY BEACH |
| State: | FL |
| Postal Code: | 324133219 |
| Phone Number: | 8506281956 |
| Fax Number: | |
| NPI Enumeration Date: | 02/17/2016 |
| NPI Last Update Date: | 02/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH13989 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |