Provider Demographics
NPI:1720317589
Name:CUTLER, NATASHA JEANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:JEANNE
Last Name:CUTLER
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 1:1070 HILINE
Mailing Address - Street 2:STE 335
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201
Mailing Address - Country:US
Mailing Address - Phone:208-681-9178
Mailing Address - Fax:208-237-9262
Practice Address - Street 1:1070 HILINE
Practice Address - Street 2:STE 335
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201
Practice Address - Country:US
Practice Address - Phone:208-681-9178
Practice Address - Fax:208-237-9262
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLSW 26814104100000X
IDLCSW-346761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker