Provider Demographics
NPI:1578837274
Name:ARMSTRONG-SUTTON, AVEN LUGH (MSW)
Entity type:Individual
Prefix:
First Name:AVEN LUGH
Middle Name:
Last Name:ARMSTRONG-SUTTON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:BLAIR
Other - Middle Name:GARNETT
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:6722 FAIR OAKS BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3812
Mailing Address - Country:US
Mailing Address - Phone:249-444-2146
Mailing Address - Fax:
Practice Address - Street 1:3020 I ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3841
Practice Address - Country:US
Practice Address - Phone:279-444-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1258261041C0700X
171M00000X
CA109476104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator