Ellen J. Lutz, L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2031 E Calumet St.
Appleton, WI 54915-4742

Phone

(920) 809-6766

Fax

(920) 358-7535

NPI assigned

Dec 31, 2019

Last updated

Dec 31, 2019By the provider in NPPES

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

Other names 1

• Miss Ellen J. Hendricks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A Village LLC

  • Mental Health Counselor
  • Appleton, WI
  • NPI 1699233270
  NPD (past)

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1649819145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 E BONA AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153657",
            "telephone_number": "920-809-6766",
            "fax_number": "920-358-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 E CALUMET ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154742",
            "telephone_number": "920-809-6766",
            "fax_number": "920-358-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "ELLEN",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "HENDRICKS",
            "middle_name": "J.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin K Lundine, APNP
• Paul Phillip Lundine, D.D.S.
• Suzanne Mary Luniak, RPH
• John Berton Luther, D.D.S.
• Lutheran Social Services of Wisconsin and Upper Michigan, Inc.
• Luxottica of America Inc (Lenscrafters #287)
• Luxottica of America Inc. (Pearle Vision #Q849)
• Luxottica of America Inc. (Target Optical #C4052)
• Luxottica Retail North America Inc (Sears Optical #1721)
• LWG Corp (Caring Senior Service of Fox Cities)

• Mental Health Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.