Provider Demographics
NPI:1366219875
Name:LUTENBACHER, ROCIO LUISA (LMSW)
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:LUISA
Last Name:LUTENBACHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:RO
Other - Middle Name:LUISA
Other - Last Name:LUTENBACHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3100 NE 83RD ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-4460
Mailing Address - Country:US
Mailing Address - Phone:816-468-0400
Mailing Address - Fax:
Practice Address - Street 1:3100 NE 83RD ST STE 1001
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-4460
Practice Address - Country:US
Practice Address - Phone:404-956-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230335011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical