Provider Demographics
NPI:1740010479
Name:SUTTON, CARRIE RUTH (MHC-LP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:RUTH
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 POTTER MTN RD
Mailing Address - Street 2:
Mailing Address - City:GILBOA
Mailing Address - State:NY
Mailing Address - Zip Code:12076-3027
Mailing Address - Country:US
Mailing Address - Phone:607-764-0202
Mailing Address - Fax:
Practice Address - Street 1:297 POTTER MTN RD
Practice Address - Street 2:
Practice Address - City:GILBOA
Practice Address - State:NY
Practice Address - Zip Code:12076-3027
Practice Address - Country:US
Practice Address - Phone:607-764-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health