Provider Demographics
NPI:1427384072
Name:SAUTER, KIM E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:E
Last Name:SAUTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KIM
Other - Middle Name:E
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851
Mailing Address - Country:US
Mailing Address - Phone:203-654-5231
Mailing Address - Fax:
Practice Address - Street 1:5 BROOK ST
Practice Address - Street 2:1A
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4549
Practice Address - Country:US
Practice Address - Phone:203-654-5231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081691041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004040655Medicaid