Cameron Craig Lutchansky

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT132853 Issued in CA

Practice address

3554 Round Barn Blvd
Santa Rosa, CA 95403-0929

Phone

(707) 571-3778

NPI assigned

May 22, 2020

Last updated

Mar 28, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1619590700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1827",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954761827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 ROUND BARN BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030929",
            "telephone_number": "707-571-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTCHANSKY",
        "first_name": "CAMERON",
        "middle_name": "CRAIG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT132853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thanh Luong, OTR/L
• James Russel Luper, MA, MFT
• Amelie Luporini, PA, RD
• Benjamin Lurie, MD
• Alexander Michael Lustberg, M.D.
• Marvin Luu
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• Amanda Ly, MD

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.