Provider Demographics
NPI:1245584937
Name:FLUTY, RENEE KATELYN (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:KATELYN
Last Name:FLUTY
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DUNCRAIG DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5789
Mailing Address - Country:US
Mailing Address - Phone:434-237-4305
Mailing Address - Fax:
Practice Address - Street 1:101 DUNCRAIG DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5789
Practice Address - Country:US
Practice Address - Phone:434-237-4305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001636101YP2500X
VA0717000703106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist