Provider Demographics
NPI:1487632808
Name:TUTENA, CHIRSTINE A (LCSW)
Entity Type:Individual
Prefix:
First Name:CHIRSTINE
Middle Name:A
Last Name:TUTENA
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:P.O. BOX 504
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15479
Mailing Address - Country:US
Mailing Address - Phone:724-872-6279
Mailing Address - Fax:
Practice Address - Street 1:EXCELA HEALTH LATROBE AREA HOSPITAL
Practice Address - Street 2:121 WEST SECOND AVE
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650
Practice Address - Country:US
Practice Address - Phone:724-537-1650
Practice Address - Fax:724-537-1918
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO129541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW012954OtherCLINICAL SOCAL WORKER LIC
PO7823Medicare UPIN
PACW012954OtherCLINICAL SOCAL WORKER LIC