Provider Demographics
NPI: | 1801028410 |
---|---|
Name: | LUTZ, CHRISTINA LAUREL (MSW, LMSW-CC, LADC) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | CHRISTINA |
Middle Name: | LAUREL |
Last Name: | LUTZ |
Suffix: | |
Gender: | F |
Credentials: | MSW, LMSW-CC, LADC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1 DELTA DR |
Mailing Address - Street 2: | |
Mailing Address - City: | WESTBROOK |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04092-4745 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 207-856-7227 |
Mailing Address - Fax: | 207-856-2112 |
Practice Address - Street 1: | 1 DELTA DR |
Practice Address - Street 2: | |
Practice Address - City: | WESTBROOK |
Practice Address - State: | ME |
Practice Address - Zip Code: | 04092-4745 |
Practice Address - Country: | US |
Practice Address - Phone: | 207-856-7227 |
Practice Address - Fax: | 207-856-2112 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-08-14 |
Last Update Date: | 2025-03-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
ME | MC21852 | 101YM0800X |
WA | RC60101365 | 101YP2500X |
1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |