Provider Demographics
NPI:1588451603
Name:LUCHT, ELIZABETH ANN (CADC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:LUCHT
Suffix:
Gender:
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PARK ST
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:50058-1322
Mailing Address - Country:US
Mailing Address - Phone:712-210-7104
Mailing Address - Fax:
Practice Address - Street 1:102 N WILSON AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:IA
Practice Address - Zip Code:50129-2116
Practice Address - Country:US
Practice Address - Phone:515-900-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20084101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)