Healthcare Provider Details

I. General information

NPI: 1669472478
Provider Name (Legal Business Name): MARTHA FOSTER LURZ L.C.S.W.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 10/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 RIDGELY AVE SUITE 304
ANNAPOLIS MD
21401-1410
US

IV. Provider business mailing address

20 RIDGELY AVE SUITE 304
ANNAPOLIS MD
21401-1410
US

V. Phone/Fax

Practice location:
  • Phone: 410-268-3140
  • Fax: 410-268-3358
Mailing address:
  • Phone: 410-268-3140
  • Fax: 410-268-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00698
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: