SHANNON COURTNEY LUTZ (NPI# 1316043128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316043128 |
| Entity Type | Individual |
| Full Name | SHANNON COURTNEY LUTZ |
| Credential | LPA |
| Practice Address |
1515 Mockingbird Ln Suite 515 Charlotte NC 28209-3236 |
| Practice Telephone | 7049994191 |
| Practice Fax Number | 9809498180 |
| Mailing Telephone | 7049994191 |
| Mailing Fax Number | 9809498180 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2013-01-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 2532 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6107208 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104898998 | Shannon Marie Lutz | Physical Therapist | 3704 Raguet St, Nacogdoches, TX 75965-2510 | 2006-02-06 |
| 1275043705 | Shannon Kirby Lutz | Physician Assistant | 2360 Maryland Rd, Willow Grove, PA 19090 | 2017-10-11 |
| 1891931895 | Shannon Rae Lutz | Social Worker | 101 N Beecher St, Bessemer, MI 49911-1109 | 2008-12-21 |
| 1063450443 | Shannon Cathleen Lutz | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2006-06-04 |
| Street Address |
1515 MOCKINGBIRD LN SUITE 515 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28209-3236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265422539 | Raymond L Grubbs | Counselor | 1515 Mockingbird Ln, Suite 412, Charlotte, NC 28209-3236 | 2005-10-26 |
| 1487957866 | Melissa Mangene Cowles | Social Worker | 1515 Mockingbird Ln, Suite 1015, Charlotte, NC 28209-3236 | 2010-12-07 |
| 1487967030 | Latricia H Penny | Counselor | 1515 Mockingbird Ln, Suite 709, Charlotte, NC 28209-3236 | 2010-07-23 |
| 1538484290 | Ark Angels LLC | In Home Supportive Care | 1515 Mockingbird Ln, Ste 515, Charlotte, NC 28209-3236 | 2010-04-06 |
| 1912234915 | Fairview Psychological Services, P.a. | Psychologist | 1515 Mockingbird Ln, Suite 215, Charlotte, NC 28209-3236 | 2009-11-11 |
| 1306076161 | Mecklenburg Open Door, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1515 Mockingbird Ln, Suite 1015, Charlotte, NC 28209-3236 | 2009-07-15 |
| 1356577308 | Rulondo Tehran Anderson Sr. | Counselor | 1515 Mockingbird Ln, Suite 405, Charlotte, NC 28209-3236 | 2009-06-04 |
| 1043495419 | Psychiatric and Forensic Associates, P.a. | Psychiatry & Neurology | 1515 Mockingbird Ln, Charlotte, NC 28209-3239 | 2008-01-04 |
| 1336336023 | Parktowne Psychological Services | Psychologist | 1515 Mockingbird Ln, Suite 212, Charlotte, NC 28209-3236 | 2007-09-26 |
| 1174720155 | Mecklenburg Open Door, Inc. | Case Management | 1515 Mockingbird Ln, Ste 1015, Charlotte, NC 28209-3236 | 2007-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194382200 | Christopher Joseph Malara | Occupational Therapy Assistant | 3600 Park Rd, Charlotte, 28209, Nc, Charlotte, NC 28209 | 2019-05-23 |
| 1982187571 | Elizabeth Black Smith | Dietitian, Registered | 5821 Fairview Road, Suite 216, Charlotte, NC 28209 | 2018-09-11 |
| 1235611690 | Shearer Counseling Services Pllc | Counselor | 5200 Park Road Ste 200-3, Charlotte, NC 28209 | 2018-09-02 |
| 1942796396 | Wade Medical Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 4400 Park Rd Unit 315, Charlotte, NC 28209 | 2018-07-09 |
| 1750803672 | Stephanie Rindner | Behavior Technician | 716 Marsh Road, Charlotte, NC 28209 | 2017-07-12 |
| 1861939621 | Carolinas Healthcare System | General Acute Care Hospital | 3329 Weston St, Charlotte, NC 28209 | 2017-01-31 |
| 1275943011 | Cameron Cunningham | Anesthesiology | 1515 Mockingbird Ln Ste 680, Charlotte, NC 28209 | 2014-05-02 |
| 1013299205 | Digital Ultrasound Associates | Spec/Tech, Cardiovascular | 4450 South Blvd Suite 4, Charlotte, NC 28209 | 2011-09-13 |
| 1801117676 | Rosemary Nmi Lucas | Physical Therapist | 2910 Selwyn Ave #359, Charlotte, NC 28209 | 2010-06-16 |
| 1194049767 | Frances Massey Harley | Speech-Language Pathologist | 715 Hartford Avenue, Sedgefield Elementary School, Charlotte, NC 28209 | 2010-03-25 |
| Find all providers in zip 28209 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720698939 | Blue Ridge Behavior Systems Inc | Psychologist | 16147 Lancaster Hwy Ste 110, Charlotte, NC 28277-4196 | 2020-08-03 |
| 1689297921 | David B Spano | Psychologist | 3205 N Mcdowell St, Charlotte, NC 28205-1552 | 2020-05-21 |
| 1447721055 | Alexis Brightman, Pllc | Psychologist | 1914 J N Pease Pl Ste 172, Charlotte, NC 28262-4504 | 2018-12-07 |
| 1366920712 | Robbie Mae & Associates, LLC | Psychologist | 4020 Lakota Ct, Charlotte, NC 28269-4074 | 2018-07-29 |
| 1295222347 | Kathleen Lucey Hack | Psychologist | 9617 Runswyck Ct, Charlotte, NC 28269-8393 | 2018-04-15 |
| 1285133405 | Jill Pratt | Psychologist | 447 S Sharon Amity Rd Ste 140, Charlotte, NC 28211-2888 | 2018-02-02 |
| 1467847426 | Marguerita Sitrin Blaker | Psychologist | 2400 Crownpoint Executive Drive, Suite 100, Office #5, Charlotte, NC 28227 | 2015-04-06 |
| 1699193672 | Elizabeth Ann Peterson-vita | Psychologist | 700 East Stonewall Street, Suite 714, Charlotte, NC 28202 | 2014-04-07 |
| 1093137093 | Epiphany Integrated Care Services, LLC | Psychologist | 4921 Albemarle Rd, Suite 203, Charlotte, NC 28205-6654 | 2014-01-09 |
| 1568891588 | Terrence Schofield | Psychologist | 6060 Piedmont Row Dr S Ste 120, Charlotte, NC 28287-2801 | 2013-11-12 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on SHANNON COURTNEY LUTZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.