Provider Demographics
NPI:1801240544
Name:CUTTANCE, JESSICA (MS, CRC, LPCA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CUTTANCE
Suffix:
Gender:F
Credentials:MS, CRC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RATTAN BAY CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8834
Mailing Address - Country:US
Mailing Address - Phone:919-709-2450
Mailing Address - Fax:
Practice Address - Street 1:4 RATTAN BAY CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8834
Practice Address - Country:US
Practice Address - Phone:919-709-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health