Provider Demographics
NPI:1871869818
Name:ANGELA LUTZI MS LPC LLC
Entity type:Organization
Organization Name:ANGELA LUTZI MS LPC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LUTZI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:610-533-5435
Mailing Address - Street 1:25 E CENTER ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2254
Mailing Address - Country:US
Mailing Address - Phone:610-533-5435
Mailing Address - Fax:
Practice Address - Street 1:25 E CENTER ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-2254
Practice Address - Country:US
Practice Address - Phone:610-533-5435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004388305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization