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Individual

BRYAN MATTHEW LUTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSW, LICDC

Contact information

Practice address
24100 CHAGRIN BLVD STE 3300, BEACHWOOD, OH 44122-5535
(800) 642-4560
(888) 391-5442
Mailing address
14020 PINE FOREST DR APT 208, NORTH ROYALTON, OH 44133-5012
(216) 387-9797

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162721
OH
104100000X
Social Worker
S.2411110
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0413873
OH
Enumeration date
06/30/2018
Last updated
01/11/2025
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