Provider Demographics
NPI:1427853431
Name:LUTZ, VON THOMAS (DSW)
Entity type:Individual
Prefix:
First Name:VON
Middle Name:THOMAS
Last Name:LUTZ
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 6TH AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-7314
Mailing Address - Country:US
Mailing Address - Phone:308-379-9977
Mailing Address - Fax:
Practice Address - Street 1:1005 6TH AVE APT 14
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-7314
Practice Address - Country:US
Practice Address - Phone:308-379-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker