Provider Demographics
NPI:1669472478
Name:LURZ, MARTHA FOSTER (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:FOSTER
Last Name:LURZ
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 RIDGELY AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1410
Mailing Address - Country:US
Mailing Address - Phone:410-268-3140
Mailing Address - Fax:410-268-3358
Practice Address - Street 1:20 RIDGELY AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1410
Practice Address - Country:US
Practice Address - Phone:410-268-3140
Practice Address - Fax:410-268-3358
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD006981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD117561100Medicaid
MD112442OtherAPS
MDQV56OtherBLUE CROSS BLUE SHIELD
MD115810OtherKAISER PERMANENTE
MD006688OtherTRICARE
MD006688OtherVALUE OPTIONS
MDR331 0001OtherBLUE CROSS BLUE SHIELD
MDR331 0001OtherBLUE CROSS BLUE SHIELD