Active NPI
Krista M Lutz
- Behavior Analyst
- Anderson, SC
National Provider Identifier
1013520063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-24-77756
- Practice address
- 4323 Old Mill Rd Ste B
Anderson, SC 29621-1117 - Phone
- (864) 671-1466
- Fax
- (615) 577-5654
- NPI assigned
- Aug 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-24-77756 | SC | Primary |
Addresses
Primary practice location
4323 Old Mill Rd Ste B
Anderson, SC 29621-1117
Mailing address
200 Elford CT
Spartanburg, SC 29306-3250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1013520063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 ELFORD CT",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293063250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4323 OLD MILL RD STE B",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296211117",
"telephone_number": "864-671-1466",
"fax_number": "615-577-5654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "KRISTA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-28",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "SC",
"license": "1-24-77756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.