Provider Demographics
NPI:1629448147
Name:ESCAMILLA, LUZ CATALINA (MSW, LSW, CAS)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:CATALINA
Last Name:ESCAMILLA
Suffix:
Gender:F
Credentials:MSW, LSW, CAS
Other - Prefix:MRS
Other - First Name:LUZ
Other - Middle Name:CATALINA
Other - Last Name:ESCAMILLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW,LSW, CAS
Mailing Address - Street 1:7863 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5553
Mailing Address - Country:US
Mailing Address - Phone:219-795-1275
Mailing Address - Fax:
Practice Address - Street 1:7243 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-1905
Practice Address - Country:US
Practice Address - Phone:219-218-3392
Practice Address - Fax:219-218-3392
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-26
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33006724A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker