Provider Demographics
NPI:1245312149
Name:LUFT, ELIZABETH A (LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:LUFT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ROBERTS ST
Mailing Address - Street 2:STE 114-A
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-5200
Mailing Address - Country:US
Mailing Address - Phone:701-478-7199
Mailing Address - Fax:701-478-1763
Practice Address - Street 1:26 ROBERTS ST N
Practice Address - Street 2:STE 114-A
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-5200
Practice Address - Country:US
Practice Address - Phone:701-478-7199
Practice Address - Fax:701-478-1763
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2012-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2012-038106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist