Provider Demographics
NPI:1639870165
Name:SCHUTTER, MARY MEGAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MEGAN
Last Name:SCHUTTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MEGAN
Other - Last Name:CREAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7445 WHISTLING DUCK WAY
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-5090
Mailing Address - Country:US
Mailing Address - Phone:770-845-1762
Mailing Address - Fax:
Practice Address - Street 1:7445 WHISTLING DUCK WAY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-5090
Practice Address - Country:US
Practice Address - Phone:770-845-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0048061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical