Provider Demographics
NPI:1235395203
Name:SUTTER, ANN B (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:B
Last Name:SUTTER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 DUNBAR DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6546
Mailing Address - Country:US
Mailing Address - Phone:770-457-6323
Mailing Address - Fax:770-457-6323
Practice Address - Street 1:2150 PEACHFORD RD
Practice Address - Street 2:SUITE I
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6520
Practice Address - Country:US
Practice Address - Phone:770-457-6323
Practice Address - Fax:770-457-6323
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0013831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical