Provider Demographics
NPI:1598719452
Name:SHUTE, HELENE (LCSW)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:SHUTE
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 1:12712 ASTON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-1463
Mailing Address - Country:US
Mailing Address - Phone:239-848-2022
Mailing Address - Fax:239-275-3302
Practice Address - Street 1:5237 SUMMERLIN COMMONS BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2158
Practice Address - Country:US
Practice Address - Phone:239-848-2022
Practice Address - Fax:239-275-2203
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW60631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1786AMedicare ID - Type UnspecifiedMEDICARE #