Provider Demographics
NPI:1710383278
Name:NUTTER, RHONDA L (LSCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:L
Last Name:NUTTER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 S OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2351
Mailing Address - Country:US
Mailing Address - Phone:316-558-6468
Mailing Address - Fax:866-316-4467
Practice Address - Street 1:560 S OLIVER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218
Practice Address - Country:US
Practice Address - Phone:316-260-1127
Practice Address - Fax:866-316-4467
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2019-07-19
Deactivation Date:2019-06-03
Deactivation Code:
Reactivation Date:2019-07-19
Provider Licenses
StateLicense IDTaxonomies
KS48111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical