Provider Demographics
NPI:1063551307
Name:LUTHER, KAREN MARIE (CLINICAL SOCIAL WORK)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:LUTHER
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 W BELOIT RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227
Mailing Address - Country:US
Mailing Address - Phone:414-327-6565
Mailing Address - Fax:414-327-6845
Practice Address - Street 1:9401 W BELOIT RD
Practice Address - Street 2:SUITE 314
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224
Practice Address - Country:US
Practice Address - Phone:414-327-6565
Practice Address - Fax:414-327-6845
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26551231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical