Provider Demographics
NPI:1912134578
Name:SHARON E. CUTTS, LCSW, LLC
Entity Type:Organization
Organization Name:SHARON E. CUTTS, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:CUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW/LCSW
Authorized Official - Phone:860-529-9577
Mailing Address - Street 1:80 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3120
Mailing Address - Country:US
Mailing Address - Phone:860-529-9577
Mailing Address - Fax:860-529-7820
Practice Address - Street 1:121 MAIN ST
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-3125
Practice Address - Country:US
Practice Address - Phone:860-529-9577
Practice Address - Fax:860-529-7820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0025271041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004159746Medicaid
CT140002527CT02OtherANTHEM BC/BS