Individual
KELLY LUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2422 CONCORD CIR, LAFAYETTE, CO 80026-3417
(303) 819-6313
Mailing address
2422 CONCORD CIR, LAFAYETTE, CO 80026-3417
(303) 819-6313
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC.0012660
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0020868
CO
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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