Provider Demographics
NPI:1538643473
Name:SUTTON, VICTORIA A
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:SUTTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 ADAMSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLRAIN
Mailing Address - State:MA
Mailing Address - Zip Code:01340-9747
Mailing Address - Country:US
Mailing Address - Phone:413-624-3652
Mailing Address - Fax:
Practice Address - Street 1:182 ADAMSVILLE RD
Practice Address - Street 2:
Practice Address - City:COLRAIN
Practice Address - State:MA
Practice Address - Zip Code:01340-9747
Practice Address - Country:US
Practice Address - Phone:413-624-3652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1169231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical