Provider Demographics
NPI:1376818674
Name:MCCUTCHEON, JONNA MICHELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JONNA
Middle Name:MICHELLE
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S RAINBOW RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1637
Mailing Address - Country:US
Mailing Address - Phone:479-254-1144
Mailing Address - Fax:479-254-1099
Practice Address - Street 1:901 S RAINBOW RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1637
Practice Address - Country:US
Practice Address - Phone:479-254-1144
Practice Address - Fax:479-254-1099
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1203019101YM0800X
ARP1506074101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health