Samantha Joy Lutz Gloria

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW97113 Issued in CA

Practice address

6762 Lexington Ave
Los Angeles, CA 90038-1217

Phone

(323) 380-7590

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1962051144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6762 LEXINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381217",
            "telephone_number": "323-380-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6762 LEXINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381217",
            "telephone_number": "323-380-7590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 W 7th St",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907313320",
            "country_code": "US",
            "telephone_number": "310-519-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLORIA",
        "first_name": "SAMANTHA",
        "middle_name": "JOY LUTZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW97113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.