Provider Demographics
NPI:1134422108
Name:CUTLER, HEIDI J (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:J
Last Name:CUTLER
Suffix:
Gender:F
Credentials:LCSW-R
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 648
Mailing Address - Street 2:117 GRAND STREET
Mailing Address - City:ALTAMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12009-0648
Mailing Address - Country:US
Mailing Address - Phone:518-861-8528
Mailing Address - Fax:
Practice Address - Street 1:117 GRAND ST
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:NY
Practice Address - Zip Code:12009-0648
Practice Address - Country:US
Practice Address - Phone:518-861-8528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR063618-11041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical