Provider Demographics
NPI:1073036190
Name:FIUTEM, COURTNEY (LISW-S)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:FIUTEM
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 COROLINE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1004
Mailing Address - Country:US
Mailing Address - Phone:740-238-1276
Mailing Address - Fax:
Practice Address - Street 1:112 COROLINE DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1004
Practice Address - Country:US
Practice Address - Phone:740-238-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1700301101YM0800X
OHI.2002470-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health