Provider Demographics
NPI:1194884973
Name:KUTZ, PAULA ANN (LCPC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:KUTZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 EXECUTIVE PL
Mailing Address - Street 2:SUITE 501
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3807
Mailing Address - Country:US
Mailing Address - Phone:630-232-7457
Mailing Address - Fax:630-232-7567
Practice Address - Street 1:1250 EXECUTIVE PL
Practice Address - Street 2:SUITE 501
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3807
Practice Address - Country:US
Practice Address - Phone:630-232-7457
Practice Address - Fax:630-232-7567
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health