Provider Demographics
NPI:1447976097
Name:LUCIANO, CASEY ALEXANDRA
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:ALEXANDRA
Last Name:LUCIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 WATER ST APT A
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-1246
Mailing Address - Country:US
Mailing Address - Phone:570-406-0740
Mailing Address - Fax:
Practice Address - Street 1:320 ABINGTON DR STE 8
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1898
Practice Address - Country:US
Practice Address - Phone:484-258-2801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health