Healthcare Provider Details
I. General information
NPI: 1477852770
Provider Name (Legal Business Name): LEMUEL YUTZY LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2011
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8401 CONNECTICUT AVE STE 1120
CHEVY CHASE MD
20815-5846
US
IV. Provider business mailing address
1201 DEKALB ST
NORRISTOWN PA
19401-3415
US
V. Phone/Fax
- Phone: 610-279-9270
- Fax: 610-279-4146
- Phone: 610-279-9270
- Fax: 610-279-4146
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | SW127933 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 19457 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: