1629448147 NPI number — MRS. LUZ CATALINA ESCAMILLA M.S.W., L.S.W, CAS

Table of content: MRS. LUZ CATALINA ESCAMILLA M.S.W., L.S.W, CAS (NPI 1629448147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629448147 NPI number — MRS. LUZ CATALINA ESCAMILLA M.S.W., L.S.W, CAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESCAMILLA
Provider First Name:
LUZ
Provider Middle Name:
CATALINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., L.S.W, CAS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ESCAMILLA
Provider Other First Name:
LUZ
Provider Other Middle Name:
CATALINA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW,LSW, CAS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1629448147
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7863 BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRILLVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46410-5553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-795-1275
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7243 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMMOND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46324-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-218-3392
Provider Business Practice Location Address Fax Number:
219-218-3392
Provider Enumeration Date:
09/26/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  33006724A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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