Healthcare Provider Details

I. General information

NPI: 1912134578
Provider Name (Legal Business Name): SHARON E. CUTTS, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MAIN ST
WETHERSFIELD CT
06109-3125
US

IV. Provider business mailing address

80 GARDEN ST
WETHERSFIELD CT
06109-3120
US

V. Phone/Fax

Practice location:
  • Phone: 860-529-9577
  • Fax: 860-529-7820
Mailing address:
  • Phone: 860-529-9577
  • Fax: 860-529-7820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number002527
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number002527
License Number StateCT

VIII. Authorized Official

Name: MS. SHARON E. CUTTS
Title or Position: MEMBER
Credential: ACSW/LCSW
Phone: 860-529-9577