Individual provider Active NPI

Karola Durette-Luckham, LMHC

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1013111418
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4838 Issued in MA
Practice address
130 Maple St Ste 205
Springfield, MA 01103-2214
Phone
(413) 739-0882
NPI assigned
Jun 12, 2007
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4838 MA Primary

Addresses

Primary practice location

130 Maple St Ste 205
Springfield, MA 01103-2214

Mailing address

68 Warregan St
Chicopee, MA 01013-2357
Phone (413) 533-7740

Other identifiers 1

IdentifierTypeStateIssuer
1307819MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125000616 MA Practitioner - Mental Health Counselor 6709239825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

367 Pine St
Springfield, MA 01105-1930
Phone (413) 737-1426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4838MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Development, Inc CurrentSince Jan 1, 2024 Accepting new patients
Center for Human Development, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Center for Psychological and Family Services Inc PastSince Jun 15, 1990 Accepting new patients

Locations

332 Birnie Ave
Springfield, MA 01107
Phone (413) 439-2189

367 Pine St
Springfield, MA 01105
Phone (413) 737-1426

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1013111418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WARREGAN ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010132357",
            "telephone_number": "413-533-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MAPLE ST STE 205",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011032214",
            "telephone_number": "413-739-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURETTE-LUCKHAM",
        "first_name": "KAROLA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307819",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.