Provider Demographics
NPI:1225213309
Name:CUTLIP, JOANNA LYNN (MED, PCC)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:LYNN
Last Name:CUTLIP
Suffix:
Gender:F
Credentials:MED, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-2202
Mailing Address - Country:US
Mailing Address - Phone:330-682-6560
Mailing Address - Fax:
Practice Address - Street 1:101 CLEVELAND AVE NW
Practice Address - Street 2:SUITE 300
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1700
Practice Address - Country:US
Practice Address - Phone:330-454-7066
Practice Address - Fax:330-454-9427
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional