Provider Demographics
NPI:1740690510
Name:TUTTLE, ADAM (LMHC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 MASS AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2600
Mailing Address - Country:US
Mailing Address - Phone:617-534-3134
Mailing Address - Fax:617-534-2611
Practice Address - Street 1:774 ALBANY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2520
Practice Address - Country:US
Practice Address - Phone:617-534-4681
Practice Address - Fax:857-288-2253
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10812101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health