Provider Demographics
NPI:1346788213
Name:LOTURCO, KELLY (MSW)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:LOTURCO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 E MAIN STREET RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3496
Mailing Address - Country:US
Mailing Address - Phone:585-344-1421
Mailing Address - Fax:585-344-8554
Practice Address - Street 1:5130 E MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3496
Practice Address - Country:US
Practice Address - Phone:585-344-1421
Practice Address - Fax:585-344-8554
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72096031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker