Healthcare Provider Details

I. General information

NPI: 1366839375
Provider Name (Legal Business Name): STEPHANY LYNNE CUTLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 E MAIN ST STE 4&5
BREVARD NC
28712-3744
US

IV. Provider business mailing address

26 E MAIN ST STE 4&5
BREVARD NC
28712-3744
US

V. Phone/Fax

Practice location:
  • Phone: 828-423-0644
  • Fax: 828-544-1201
Mailing address:
  • Phone: 828-423-0644
  • Fax: 828-544-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC012437
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: