Active NPI
Larry W Lutz II, MS
- Professional Counselor
- Mountain Home, ID
National Provider Identifier
1386662294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC-4128
- Practice address
- 210 N 3Rd E
Mountain Home, ID 83647-2733 - Phone
- (208) 284-0959
- Fax
- (208) 587-4269
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LCPC-4128 | ID | Primary |
Addresses
Primary practice location
210 N 3Rd E
Mountain Home, ID 83647-2733
Mailing address
210 N 3Rd E
Mountain Home, ID 83647-2733
Phone (208) 284-0959
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC-4128 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1386662294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N 3RD E",
"city": "MOUNTAIN HOME",
"state": "ID",
"postal_code": "836472733",
"telephone_number": "208-284-0959",
"fax_number": "208-587-4269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N 3RD E",
"city": "MOUNTAIN HOME",
"state": "ID",
"postal_code": "836472733",
"telephone_number": "208-284-0959",
"fax_number": "208-587-4269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "LARRY",
"middle_name": "W",
"name_suffix": "II",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC-4128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.