Basic Information
| Provider Information | |||||||||
| NPI: | 1861749061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUTTON | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | MILLARD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 MARYLAND RD | ||||||||
| Address2: | SUITE #400 | ||||||||
| City: | WILLOW GROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190901216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154815450 | ||||||||
| FaxNumber: | 2154815435 | ||||||||
| Practice Location | |||||||||
| Address1: | 2500 MARYLAND RD | ||||||||
| Address2: | SUITE #309 | ||||||||
| City: | WILLOW GROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190901216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154815450 | ||||||||
| FaxNumber: | 2154815435 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2012 | ||||||||
| LastUpdateDate: | 12/02/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW018247 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.