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General NPI Number Information
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NPI Number | 1942981782
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Entity Type | Individual
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Provider Name | JEAN HARTER SHUTT LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 107 W BEEBE AVE
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City | CHAMBERLAIN
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State | SD
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Zip | 57325-1223
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Country | US
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Telephone | 605-734-6535
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Fax |
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Provider Business Mailing Address
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Address Line | 910 W HAVENS AVE
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City | MITCHELL
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State | SD
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Zip | 57301-3831
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Country | US
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Telephone | 605-996-9686
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Fax | 605-996-1624
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6301
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License Number State | SD
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