Provider Demographics
NPI:1104713791
Name:KRISTINE LUTZ COUNSELING PLLC
Entity type:Organization
Organization Name:KRISTINE LUTZ COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:651-482-9361
Mailing Address - Street 1:900 LONG LAKE RD STE 320
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6439
Mailing Address - Country:US
Mailing Address - Phone:651-482-9361
Mailing Address - Fax:
Practice Address - Street 1:900 LONG LAKE RD STE 320
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6439
Practice Address - Country:US
Practice Address - Phone:651-482-9361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty