Provider Demographics
NPI:1366101792
Name:LUCKY DAY COUNSELING, LLC
Entity type:Organization
Organization Name:LUCKY DAY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELOS
Authorized Official - Middle Name:
Authorized Official - Last Name:NONIKOS
Authorized Official - Suffix:
Authorized Official - Credentials:LADC-I
Authorized Official - Phone:617-383-1033
Mailing Address - Street 1:529R HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1858
Mailing Address - Country:US
Mailing Address - Phone:617-383-1033
Mailing Address - Fax:781-251-2276
Practice Address - Street 1:529R HIGH ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1858
Practice Address - Country:US
Practice Address - Phone:617-383-1033
Practice Address - Fax:781-251-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty