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Individual
MR. LUKE GEORGE MIHAYLO JR.
Active
Individual
MR. LUKE GEORGE MIHAYLO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
30000223CT01-LADC
CT
1041C0700X
Clinical Social Worker
Primary
140004395CT02
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11467756
UNIVERSAL CREDENTIALING
CT
01
—
140004395CT02
LICENSED CLINICAL SW
CT
01
—
30000223CT01-LADC
LICENSED DRUG/ALCOHOL
CT
Enumeration date
10/25/2006
Last updated
01/15/2021
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