Provider Demographics
NPI:1487252615
Name:UNNELAND, LUKE THOMAS (LCSW)
Entity type:Individual
Prefix:MR
First Name:LUKE
Middle Name:THOMAS
Last Name:UNNELAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NEW ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-3107
Mailing Address - Country:US
Mailing Address - Phone:914-400-7535
Mailing Address - Fax:914-239-8797
Practice Address - Street 1:78 N VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4606
Practice Address - Country:US
Practice Address - Phone:914-400-7535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0969361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty