Provider Demographics
NPI:1588790778
Name:LUKE, JANE WINFORD (LSCW, BCD)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:WINFORD
Last Name:LUKE
Suffix:
Gender:F
Credentials:LSCW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CAPITOL PL
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-4706
Mailing Address - Country:US
Mailing Address - Phone:302-368-7520
Mailing Address - Fax:302-368-1184
Practice Address - Street 1:523 CAPITOL TRL
Practice Address - Street 2:WORKCARE, WINDY HILLS PROFESSIONAL CENTER
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-3859
Practice Address - Country:US
Practice Address - Phone:302-368-1184
Practice Address - Fax:302-368-1184
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-0000220104100000X
BCD 10511104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
52-2387175OtherTIN