Provider Demographics
NPI:1205135274
Name:SWITZER, LUELLYN (MS, LPC)
Entity type:Individual
Prefix:
First Name:LUELLYN
Middle Name:
Last Name:SWITZER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-9305
Mailing Address - Country:US
Mailing Address - Phone:662-418-7007
Mailing Address - Fax:
Practice Address - Street 1:114 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2953
Practice Address - Country:US
Practice Address - Phone:662-418-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional