Provider Demographics
NPI:1962147041
Name:LUTTRALL, JAMES DAVID (LPC, LAC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DAVID
Last Name:LUTTRALL
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 GLENROCK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80926-9626
Mailing Address - Country:US
Mailing Address - Phone:719-291-2439
Mailing Address - Fax:
Practice Address - Street 1:1295 GLENROCK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80926-9626
Practice Address - Country:US
Practice Address - Phone:719-291-2439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health