Kelsey Lutz, MA, LPC

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

508 N Center St
Gardner, IL 60424-7054

Phone

(815) 252-1151

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Waterford Counseling and Psychological Services, PC

  • Clinical Psychologist
  • Aurora, IL
  • NPI 1104250067
  Medicare reassignment NPD
• Chicvara & Associates

  • Clinical Psychologist
  • Mokena, IL
  • NPI 1043590342
  NPD (past)

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1366093775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N CENTER ST",
            "city": "GARDNER",
            "state": "IL",
            "postal_code": "604247054",
            "telephone_number": "815-252-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 N CENTER ST",
            "city": "GARDNER",
            "state": "IL",
            "postal_code": "604247054",
            "telephone_number": "815-252-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "KELSEY",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2023-03-29",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kelseylutzlpc@gmail.com",
            "affiliation": "N",
            "address_1": "508 N Center St",
            "city": "Gardner",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604247054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gardner Fire Protection District
• Gardner Pharmacy Inc
• Gardner S Wilmington THS Dist 73
• Gardner Volunteer Fire Department
• Jack James, PA-C
• Renee Moore
• Melinda Sue Mounts
• Sharon K. Pickles
• Allison Lee Scudieri
• Seven Carrot Learning, LLC

• Behavior Technician in Gardner, IL
• Providers in Gardner, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.