Healthcare Provider Details

I. General information

NPI: 1740850262
Provider Name (Legal Business Name): HELEN CHERIE HUTTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date: 10/19/2021
Reactivation Date: 10/29/2021

III. Provider practice location address

2900 14TH AVE S
GRAND FORKS ND
58201-4042
US

IV. Provider business mailing address

811 OAKFIELD DR
GRAND FORKS ND
58201-8327
US

V. Phone/Fax

Practice location:
  • Phone: 701-741-1979
  • Fax: 701-787-7901
Mailing address:
  • Phone: 701-741-1979
  • Fax: 701-787-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3899
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: