Provider Demographics
NPI:1003378258
Name:RUTTER, JANET ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ANN
Last Name:RUTTER
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 1:703 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:CAYUGA
Mailing Address - State:IN
Mailing Address - Zip Code:47928-8207
Mailing Address - Country:US
Mailing Address - Phone:765-492-9042
Mailing Address - Fax:765-492-9048
Practice Address - Street 1:703 W PARK ST
Practice Address - Street 2:
Practice Address - City:CAYUGA
Practice Address - State:IN
Practice Address - Zip Code:47928-8207
Practice Address - Country:US
Practice Address - Phone:765-492-9042
Practice Address - Fax:765-492-9048
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011980101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional