Mark W. Lutz, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-1981 Issued in AZ

Practice address

102 N Arizona Blvd, Suite D
Coolidge, AZ 85128-5800

Phone

(480) 580-4036

NPI assigned

Mar 30, 2007

Last updated

Jun 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1508986852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N ARIZONA BLVD, SUITE D",
            "city": "COOLIDGE",
            "state": "AZ",
            "postal_code": "851285800",
            "telephone_number": "480-580-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N ARIZONA BLVD, SUITE D",
            "city": "COOLIDGE",
            "state": "AZ",
            "postal_code": "851285800",
            "telephone_number": "480-580-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-1981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "724014",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Coolidge, AZ
• Providers in Coolidge, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.