Provider Demographics
NPI:1588741094
Name:LUKA, ALEXIA DORIAN (LICSW, CCDC)
Entity type:Individual
Prefix:MRS
First Name:ALEXIA
Middle Name:DORIAN
Last Name:LUKA
Suffix:
Gender:F
Credentials:LICSW, CCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 PROFESSIONAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879
Mailing Address - Country:US
Mailing Address - Phone:240-683-6202
Mailing Address - Fax:
Practice Address - Street 1:610 PROFESSIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879
Practice Address - Country:US
Practice Address - Phone:240-683-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1435101YA0400X
MD174701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)