Provider Demographics
NPI:1376737916
Name:LUTZ, ELIZABETH A (MSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:A
Last Name:LUTZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:A
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2201 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2843
Mailing Address - Country:US
Mailing Address - Phone:606-327-4000
Mailing Address - Fax:606-327-4942
Practice Address - Street 1:624 9TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2122
Practice Address - Country:US
Practice Address - Phone:304-529-9152
Practice Address - Fax:304-529-0047
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2699104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker