Provider Demographics
NPI:1568114866
Name:CUTTITA, NICOLE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:CUTTITA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 4TH AVE # 1050
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2718
Mailing Address - Country:US
Mailing Address - Phone:646-535-9803
Mailing Address - Fax:
Practice Address - Street 1:520 FRANKLIN AVE STE L6-A
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5806
Practice Address - Country:US
Practice Address - Phone:646-430-9417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9364101YP2500X
NY013020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY013020OtherNY STATE EDUCATION DEPARTMENT