Audrey Alcala Lutz, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00944325 Issued in WV

Practice address

3000 Coombs Farm Rd Ste 102
Morgantown, WV 26508-1190

Phone

(304) 777-0650

NPI assigned

May 7, 2019

Last updated

May 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GR&W, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morgantown, WV
  • NPI 1992665723
  NPD
• Women in Balance, LLC

  • Professional Counselor
  • Morgantown, WV
  • NPI 1215356258
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1316502131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 COOMBS FARM RD STE 102",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081190",
            "telephone_number": "304-777-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COOMBS FARM RD STE 102",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081190",
            "telephone_number": "304-777-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "AUDREY",
        "middle_name": "ALCALA",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "BP00944325",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00944325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Lukomski
• Angela Corinne Lukow, MD
• Jennifer L Lultschik, M.D.
• Melissa Luna Rubina, DDS
• Kelsie Elizabeth Lusk, PA-C
• Abigail Luzader
• Penelope Luzader
• Madison Lyle
• Abigail Lynch
• Grace Lynch, MS

• Clinical Social Worker in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.