Provider Demographics
NPI:1124368741
Name:SUTTER, AMY S (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:SUTTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 LAWRENCEBURG FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41080-8702
Mailing Address - Country:US
Mailing Address - Phone:859-445-3556
Mailing Address - Fax:502-567-5620
Practice Address - Street 1:2440 LAWRENCEBURG FERRY RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:KY
Practice Address - Zip Code:41080-8702
Practice Address - Country:US
Practice Address - Phone:859-445-3556
Practice Address - Fax:502-567-5620
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3257104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker