Provider Demographics
NPI:1003839895
Name:RUTTER, STEVEN GERALD (MSW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:GERALD
Last Name:RUTTER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E 36TH ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3450
Mailing Address - Country:US
Mailing Address - Phone:646-483-1930
Mailing Address - Fax:772-361-6386
Practice Address - Street 1:36 E 36TH ST APT 5D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3450
Practice Address - Country:US
Practice Address - Phone:646-483-1930
Practice Address - Fax:772-361-6386
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW PRO23427-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN13092Medicare ID - Type UnspecifiedMEDICARE