Kelsey Lutz, MA, LPC
Behavior Technician in Gardner, IL. Individual provider (NPI-1).
NPI number1366093775
StatusActive
Last updated in NPPESMar 29, 2023
Details
- NPI
- 1366093775
- Entity type
- Individual (NPI-1)
- Name
- Kelsey Lutz
- Credential
- MA, LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 26, 2019
- Certification date
- Dec 8, 2020
- Last updated
- Mar 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
508 N Center StGardner, IL 60424-7054
Phone 815-252-1151
Mailing address
508 N Center StGardner, IL 60424-7054
Phone 815-252-1151
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