Provider Demographics
NPI:1912138009
Name:KUTTNER, JESSICA (LICSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KUTTNER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BUCKLAND ROAD
Mailing Address - Street 2:STE D
Mailing Address - City:ASHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01330
Mailing Address - Country:US
Mailing Address - Phone:413-628-3890
Mailing Address - Fax:
Practice Address - Street 1:9 COLLEGE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1421
Practice Address - Country:US
Practice Address - Phone:413-534-7400
Practice Address - Fax:413-534-7483
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1151541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical