Provider Demographics
NPI:1063065290
Name:KING, LUKE PATRICK (LICSW)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:PATRICK
Last Name:KING
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 FRANKLIN ST STE 809
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1508
Mailing Address - Country:US
Mailing Address - Phone:617-990-9945
Mailing Address - Fax:
Practice Address - Street 1:77 FRANKLIN ST STE 809
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1508
Practice Address - Country:US
Practice Address - Phone:617-990-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609651581041C0700X
MA2262051041C0700X
MA1259211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical