Individual
STEVEN LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., LP
Contact information
Practice address
8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 379-0444
(651) 379-0448
Mailing address
8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 379-0444
(651) 379-0448
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4421
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172007
BHP/FAIRVIEW/PREFERRED 1
MN
01
—
336R2LU
BCBS ID#
MN
05
—
450620100
—
MN
01
—
463725
VALUE OPTIONS
MN
01
—
468166000
MAGELLAN/AETNA ID#
MN
01
—
55042A004
TRICARE/TRIWEST
MN
01
—
HP55874
HEALTH PARTNERS ID#
MN
Enumeration date
10/24/2005
Last updated
12/23/2011
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