Provider Demographics
NPI:1932426533
Name:LUKAC EVANS, SHIRLEY SOPHIE (MCAT, LPC)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:SOPHIE
Last Name:LUKAC EVANS
Suffix:
Gender:F
Credentials:MCAT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7753
Mailing Address - Country:US
Mailing Address - Phone:610-326-9224
Mailing Address - Fax:
Practice Address - Street 1:35 N 6TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3668
Practice Address - Country:US
Practice Address - Phone:610-373-4281
Practice Address - Fax:610-373-3779
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional