Healthcare Provider Details

I. General information

NPI: 1255436754
Provider Name (Legal Business Name): LUZIO & ASSOCIATES BEHAVIORAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 WASHINGTON AVE STE 300
EVANSVILLE IN
47714-0805
US

IV. Provider business mailing address

4411 WASHINGTON AVE STE 300
EVANSVILLE IN
47714-0805
US

V. Phone/Fax

Practice location:
  • Phone: 812-479-1916
  • Fax: 812-479-5014
Mailing address:
  • Phone: 812-479-1916
  • Fax: 812-479-5014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LINDI BONESTEEL
Title or Position: OFFICE MANAGER
Credential:
Phone: 812-479-1916