Provider Demographics
NPI:1306402375
Name:ESQUIVEL, LUZ (LMSW)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1905
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-1905
Mailing Address - Country:US
Mailing Address - Phone:620-275-0644
Mailing Address - Fax:620-272-0239
Practice Address - Street 1:506 AVENUE L
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-5319
Practice Address - Country:US
Practice Address - Phone:620-227-8566
Practice Address - Fax:620-225-5824
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11129104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker