Provider Demographics
NPI:1497903967
Name:CUTLER, REBECCA JANE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JANE
Last Name:CUTLER
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 1:24 COPELAND AVE
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:NY
Mailing Address - Zip Code:13077-1529
Mailing Address - Country:US
Mailing Address - Phone:607-749-5711
Mailing Address - Fax:607-753-3165
Practice Address - Street 1:24 COPELAND AVE
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:NY
Practice Address - Zip Code:13077-1529
Practice Address - Country:US
Practice Address - Phone:607-749-5711
Practice Address - Fax:607-753-3165
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0721041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical