Provider Demographics
NPI:1770245854
Name:CUTTRAY, ERIKA DANIELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:DANIELLE
Last Name:CUTTRAY
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:PO BOX 1544
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-8009
Mailing Address - Country:US
Mailing Address - Phone:470-889-9232
Mailing Address - Fax:
Practice Address - Street 1:7881 WINKMAN DR
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-2036
Practice Address - Country:US
Practice Address - Phone:470-889-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0076161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty