Provider Demographics
NPI:1871783621
Name:LUTY-KABRHEL, JESSICA ELIZABETH (LCSW-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:LUTY-KABRHEL
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LUTY
Other - Last Name:KABRHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:6849 LITTLEWOOD COURT
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784
Mailing Address - Country:US
Mailing Address - Phone:410-209-0455
Mailing Address - Fax:
Practice Address - Street 1:6849 LITTLEWOOD COURT
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784
Practice Address - Country:US
Practice Address - Phone:410-209-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD139411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical