Provider Demographics
NPI:1427759067
Name:LUKE, TAMMY LATOYA (MS, LPC, CRC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LATOYA
Last Name:LUKE
Suffix:
Gender:F
Credentials:MS, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HUNTINGTON RD STE 803
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7216
Mailing Address - Country:US
Mailing Address - Phone:706-254-5910
Mailing Address - Fax:
Practice Address - Street 1:1 HUNTINGTON RD STE 803
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7216
Practice Address - Country:US
Practice Address - Phone:470-470-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013377101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional