| Doctor Name: | MICHAEL SHANE LUCK |
| NPI Number: | 1659736338 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | LPC-15864 |
| Business Practice Address: | 61 West Center Snowflake, AZ - 85937 |
| Business Phone Number: | 4805106780 |
| Business Fax Number: | |
| Mailing Address: | 2638 Old School House Rd, SHOW LOW |
| State: | AZ |
| Postal Code: | 859019433 |
| Phone Number: | 4805106780 |
| Fax Number: | |
| NPI Enumeration Date: | 12/22/2015 |
| NPI Last Update Date: | 12/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC-15864 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |