Provider Demographics
NPI:1386009918
Name:CUTRIGHT, KELLI ELDER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELLI
Middle Name:ELDER
Last Name:CUTRIGHT
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 1:1221 1ST ST S APT 5C
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-6444
Mailing Address - Country:US
Mailing Address - Phone:904-325-4370
Mailing Address - Fax:
Practice Address - Street 1:100 EXECUTIVE WAY STE 206
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2714
Practice Address - Country:US
Practice Address - Phone:904-325-4370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-26
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW132441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical