Healthcare Provider Details

I. General information

NPI: 1629448147
Provider Name (Legal Business Name): LUZ CATALINA ESCAMILLA M.S.W., L.S.W, CAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LUZ CATALINA ESCAMILLA MSW,LSW, CAS

II. Dates (important events)

Enumeration Date: 09/26/2015
Last Update Date: 06/09/2023
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7243 JEFFERSON AVE
HAMMOND IN
46324-1905
US

IV. Provider business mailing address

7863 BROADWAY
MERRILLVILLE IN
46410-5553
US

V. Phone/Fax

Practice location:
  • Phone: 219-218-3392
  • Fax: 219-218-3392
Mailing address:
  • Phone: 219-795-1275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33006724A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: