Basic Information
| Provider Information | |||||||||
| NPI: | 1366839375 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUTLER | ||||||||
| FirstName: | STEPHANY | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 E MAIN ST STE 4&5 | ||||||||
| Address2: | |||||||||
| City: | BREVARD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287123744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284230644 | ||||||||
| FaxNumber: | 8285441201 | ||||||||
| Practice Location | |||||||||
| Address1: | 26 E MAIN ST STE 4&5 | ||||||||
| Address2: | |||||||||
| City: | BREVARD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287123744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284230644 | ||||||||
| FaxNumber: | 8285441201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2015 | ||||||||
| LastUpdateDate: | 10/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C012437 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.