John Carl Lutz, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

7517 Issued in MA

Practice address

148 Worcester St
West Boylston, MA 01583-1751

Phone

(508) 835-1735

Fax

(508) 835-1736

NPI assigned

Jan 13, 2007

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Pediatric Behavioral Health, LLC

  • Marriage & Family Therapist
  • West Boylston, MA
  • NPI 1487779104

  Clinical Child & Adolescent

  NPD (past)

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699826172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735",
            "fax_number": "508-835-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735",
            "fax_number": "508-835-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "JOHN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "7517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ellen Lonergan, L.M.H.C.
• Lori a Heyler OD LLC
• Zoribett Lozada
• Lindsey Mae Luksha
• Lutz Child and Family Associates, P.C.
• Julie Ellen Lysiak, RN MS CS
• Kaitlin Mackay, BCBA
• Stephanie Malo
• Mama Doris Foundation Inc
• Emily Mandara

• Clinical Child & Adolescent Psychologist in West Boylston, MA
• Providers in West Boylston, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.