Individual provider Active NPI

Brian Lueck, MA

  • Psychologist
  • Princeton, WV
National Provider Identifier
1316555170
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1255 Issued in WV
Practice address
211 Hunter Park
Princeton, WV 24740-2532
Phone
(304) 487-6121
Fax
(304) 487-8741
NPI assigned
Jul 17, 2020
Last updated
Jul 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1255 WV Primary

Addresses

Primary practice location

211 Hunter Park
Princeton, WV 24740-2532

Mailing address

211 Hunter Park
Princeton, WV 24740-2532
Phone (304) 487-6121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1316555170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HUNTER PARK",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402532",
            "telephone_number": "304-487-6121",
            "fax_number": "304-487-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HUNTER PARK",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402532",
            "telephone_number": "304-487-6121",
            "fax_number": "304-487-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUECK",
        "first_name": "BRIAN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "1255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.