Provider Demographics
NPI:1942061908
Name:NUTTER, STEVIE MARIE (CDCA)
Entity Type:Individual
Prefix:
First Name:STEVIE
Middle Name:MARIE
Last Name:NUTTER
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 S 10TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-2084
Mailing Address - Country:US
Mailing Address - Phone:740-589-2832
Mailing Address - Fax:
Practice Address - Street 1:57 TOWN HIGHWAY 1275
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:OH
Practice Address - Zip Code:45619
Practice Address - Country:US
Practice Address - Phone:740-589-2832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH186260101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)