Provider Demographics
NPI:1497816516
Name:CRITES-LUTZ, JUDITH JEAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:JEAN
Last Name:CRITES-LUTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1389
Mailing Address - Street 2:16209 US HWY 160
Mailing Address - City:FORSYTH
Mailing Address - State:MO
Mailing Address - Zip Code:65653-1389
Mailing Address - Country:US
Mailing Address - Phone:417-546-6003
Mailing Address - Fax:417-546-6005
Practice Address - Street 1:398 STATE HWY BB
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:MO
Practice Address - Zip Code:65673-0960
Practice Address - Country:US
Practice Address - Phone:417-334-2502
Practice Address - Fax:417-334-6203
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional