Organization Active NPI

Luchansky Psychological Services LLC

  • Clinical Psychologist
  • Clarks Summit, PA
National Provider Identifier
1184190233
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LUCHANSKY PSYCHOLOGICAL SERVICES LLC
Practice address
395 Bedford St Ste C
Clarks Summit, PA 18411-1801
Phone
(570) 954-6961
Fax
(570) 319-9674
NPI assigned
Oct 16, 2018
Last updated
Oct 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Authorized official

Name
Amanda Luchansky, PSYDNPI 1316329535
Title
Licensed Psychologist/Owner
Phone
(570) 954-6961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

395 Bedford St Ste C
Clarks Summit, PA 18411-1801

Mailing address

395 Bedford St Ste C
Clarks Summit, PA 18411-1801
Phone (570) 954-6961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190228002387 PA Part B Supplier - Clinic/Group Practice 6901145358 Receives reassigned benefits from 1 practitioner
Practice locations: Clarks Summit, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1184190233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 BEDFORD ST STE C",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111801",
            "telephone_number": "570-954-6961",
            "fax_number": "570-319-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 BEDFORD ST STE C",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111801",
            "telephone_number": "570-954-6961",
            "fax_number": "570-319-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCHANSKY PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "LUCHANSKY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "570-954-6961",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.