Organization Active NPI

Lutz Center for Counseling and Assessment, LLC

  • School Psychologist
  • Gulf Breeze, FL
National Provider Identifier
1396055331
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS795 Issued in FL
Legal business name
LUTZ CENTER FOR COUNSELING AND ASSESSMENT, LLC
Practice address
3612 Quail Run Rd
Gulf Breeze, FL 32563-2836
Phone
(850) 910-1806
Fax
(866) 960-8806
NPI assigned
Oct 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Authorized official

Name
Mr. Joshua A Lutz, ED.S.
Title
Owner
Phone
(850) 910-1806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X SS795 FL Primary

Addresses

Primary practice location

3612 Quail Run Rd
Gulf Breeze, FL 32563-2836

Mailing address

91 Bay Bridge Dr
D
Gulf Breeze, FL 32561-4468
Phone (850) 910-1806

National Provider Directory

National Provider Directory

Locations

91 Bay Bridge Dr
#D
Gulf Breeze, FL 32561

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1396055331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 BAY BRIDGE DR",
            "address_2": "D",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614468",
            "telephone_number": "850-910-1806",
            "fax_number": "866-960-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 QUAIL RUN RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632836",
            "telephone_number": "850-910-1806",
            "fax_number": "866-960-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTZ CENTER FOR COUNSELING AND ASSESSMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-910-1806",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED.S."
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.