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CHARRYSE FOUQUETTE LUCKEY PH.D BCBA-D NPI 1073006524


NPI Information

NPI: 1073006524
Provider Name: CHARRYSE FOUQUETTE LUCKEY, PH.D, BCBA-D
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

PECOS Registration: Yes

Address:
1830 27TH ST SE UNIT E
SAINT CLOUD, MN
ZIP 56304
Phone: (651) 503-7696
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Charryse Fouquette Luckey, PH.D, BCBA-D is a clinical psychologist in Saint Cloud, MN. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. Charryse Fouquette Luckey, PH.D, BCBA-D NPI is 1073006524. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1830 27TH ST SE UNIT E
SAINT CLOUD, MN
ZIP 56304-601
Phone: (651) 503-7696

The NPI 1073006524 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 6/10/2018 and was last updated on 10/26/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103K00000XBehavior Analyst1-05-2231MINNESOTANo
2103TC0700XPsychologistClinical6660MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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