Individual
JORDAN LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
372 MCLAWS CIR STE 1&2, WILLIAMSBURG, VA 23185-5636
(540) 207-1108
Mailing address
5104 GREENWICH MEWS, WILLIAMSBURG, VA 23188-8515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103043
VA
101YP2500X
Professional Counselor
Primary
0701006350
VA
106H00000X
Marriage & Family Therapist
0717001413
VA
Other
Enumeration date
10/08/2015
Last updated
11/22/2016
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