Provider Demographics
NPI:1629535984
Name:SHUTT, THUY LIEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:THUY
Middle Name:LIEN
Last Name:SHUTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LIEN
Other - Middle Name:
Other - Last Name:SHUTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:640 TURK ST APT 18
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3235
Mailing Address - Country:US
Mailing Address - Phone:415-963-2585
Mailing Address - Fax:
Practice Address - Street 1:640 TURK ST APT 18
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3235
Practice Address - Country:US
Practice Address - Phone:415-963-2585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW279121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical