Provider Demographics
NPI:1285201020
Name:LUTY, JENNIFER NORWOOD (NCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NORWOOD
Last Name:LUTY
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:NORWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1203 OLA AVE
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-1454
Mailing Address - Country:US
Mailing Address - Phone:256-656-6915
Mailing Address - Fax:
Practice Address - Street 1:1203 OLA AVE
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-1454
Practice Address - Country:US
Practice Address - Phone:256-656-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health