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General NPI Number Information
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NPI Number | 1144301516
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Entity Type | Individual
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Provider Name | CAROLE LELAND LUTNESS LCSW LAADC
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 23560 PEACHLAND AVE #204
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City | NEWHALL
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State | CA
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Zip | 91321
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Country | US
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Telephone | 661-755-7524
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Fax | 661-799-3632
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Provider Business Mailing Address
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Address Line | 25439 VIA MACARENA
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City | VALENCIA
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State | CA
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Zip | 91355
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Country | US
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Telephone | 661-755-7524
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Fax | 661-799-3632
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 18703
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License Number State | CA
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