Provider Demographics
NPI:1144606450
Name:LUTCHMAN, MICHELLE M (CMSW, LCSWA, CCM)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:M
Last Name:LUTCHMAN
Suffix:
Gender:F
Credentials:CMSW, LCSWA, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 JONES FERRY RD APT R10
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2181
Mailing Address - Country:US
Mailing Address - Phone:347-665-2763
Mailing Address - Fax:
Practice Address - Street 1:137 SUGAR MAPLE CT
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-9246
Practice Address - Country:US
Practice Address - Phone:347-665-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP015822104100000X
NY098364104100000X
NCB001020104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker