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General NPI Number Information
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NPI Number | 1487217998
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Entity Type | Organization
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Legal Business Name | CUTTING EDGE INC
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 1408 S WALNUT ST STE A
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5888
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Country | US
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Telephone | 812-322-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 9191 S ROCKPORT RD
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City | SPRINGVILLE
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State | IN
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Zip | 47462-8400
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Country | US
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Telephone | 812-322-4515
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Fax |
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Authorized Official
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Title or Position | TIN OWNER
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Name | JAMES BAUGH
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Credential | LCSW
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Telephone | 812-322-4515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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