Dr. Martie Ryan Lukanich

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

DR. MARTIE RYAN LUKANICH

Practice address

9601 165TH St
Suite 6
Orland Park, IL 60467-5660

Phone

(708) 829-8277

Fax

(708) 352-2305

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Martie Ryan Lukanich, PSY.D.,LCPC

Title

Professional Counselor

Phone

(708) 829-8277

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740403476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 165TH ST",
            "address_2": "SUITE 6",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675660",
            "telephone_number": "708-829-8277",
            "fax_number": "708-352-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 165TH ST",
            "address_2": "SUITE 6",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675660",
            "telephone_number": "708-829-8277",
            "fax_number": "708-352-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARTIE RYAN LUKANICH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUKANICH",
        "authorized_official_first_name": "MARTIE",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "708-829-8277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D.,LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Orland Park, IL
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• Professional Counselor in Illinois

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