Provider Demographics
NPI:1073868022
Name:LUETKEHANS, KATHRYN H (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:H
Last Name:LUETKEHANS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 SANNA WIND WAY
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-9605
Mailing Address - Country:US
Mailing Address - Phone:425-922-8394
Mailing Address - Fax:
Practice Address - Street 1:5492 HARBOR AVE
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-3002
Practice Address - Country:US
Practice Address - Phone:425-922-8394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12728101YM0800X
WALH61074608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2164660Medicaid
CO757244Medicaid