Individual
MR. MICHAEL J. LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
99 W MAIN ST, GOUVERNEUR, NY 13642-1371
(315) 386-2189
(315) 287-0285
Mailing address
80 STATE HIGHWAY 310, SUITE 1, CANTON, NY 13617-1493
(315) 386-2189
(315) 386-2435
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CREDENTIAL17925
NY
Other
Enumeration date
11/26/2008
Last updated
05/06/2010
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