Mitchell Alan Luchansky, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

ME77530 Issued in FL

Practice address

267 Old Moody Blvd
Palm Coast, FL 32164-2470

Phone

(386) 313-5752

Fax

(386) 313-5801

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Ship Port Psych Services LLC

  • Health Psychologist
  • New Port Richey, FL
  • NPI 1669798278
  NPD (past)
• Wuesthoff Memorial Hospital Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Rockledge, FL
  • NPI 1164685756
  NPD (past)
• The Teen Project, Inc.

  • Substance Abuse Rehabilitation Facility
  • Sun Valley, CA
  • NPI 1194677880
  NPD (past)
• The Teen Project, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Sun Valley, CA
  • NPI 1457908618
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1447322367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 OLD MOODY BLVD",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642470",
            "telephone_number": "386-313-5752",
            "fax_number": "386-313-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 OLD MOODY BLVD",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642470",
            "telephone_number": "386-313-5752",
            "fax_number": "386-313-5801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8142 Sunland Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun Valley",
            "state": "CA",
            "postal_code": "913523948",
            "country_code": "US",
            "telephone_number": "818-582-8832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCHANSKY",
        "first_name": "MITCHELL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G55527",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME77530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015704300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loving Angels Assisted Living Facilities,Inc
• Loving Angels Assisted Living, Inc.
• Yolaunda Renee Lowe
• Jennifer A Lucas, SLP
• Yolanda Lucas, M.D.
• Anais Luciano
• Matthew Stephen Luecke, FNP-BC
• Karen Lugo Morales, DR., DC, LMT
• Gialys Ailema Luis, BCBA
• Margaret Lukaszewski

• Child & Adolescent Psychiatry Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Child & Adolescent Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.