Stacey Luczejko, ED.S, MA, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC005745 Issued in PA

Practice address

12022 Chancellor Blvd
Port Charlotte, FL 33953-1031

Phone

(215) 586-0847

NPI assigned

Mar 9, 2011

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1336447770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12022 CHANCELLOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339531031",
            "telephone_number": "215-586-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12022 CHANCELLOR BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339531031",
            "telephone_number": "215-586-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCZEJKO",
        "first_name": "STACEY",
        "credential": "ED.S, MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario J Lopez, MD
• Lovely Physician Care Corp
• Todd Michael Lovero, O.D.
• LP Port Charlotte LLC (Signature HealthCARE of Port Charlotte)
• Kenneth Lloyd Luberger Jr.
• Katherine Ann Ludeman, ARNP
• Luis F Fernandez MD PA
• Luis Fernandez, MD
• Luis G Marmol MD PA
• Randyel Luis, RPH

• Professional Counselor in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.