Provider Demographics
NPI:1598203127
Name:LUTZ, EUGENIA DIANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:DIANNE
Last Name:LUTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22868 ROUTE 68
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8566
Mailing Address - Country:US
Mailing Address - Phone:814-227-2941
Mailing Address - Fax:814-297-2044
Practice Address - Street 1:22868 ROUTE 68
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8566
Practice Address - Country:US
Practice Address - Phone:814-227-2941
Practice Address - Fax:814-227-2946
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133961104100000X
PACW021516104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker