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NPI Code Detail

MEDICARE: DEBORAH ANN REUTTER LCSW

MEDICARE: DEBORAH ANN REUTTER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34001751IN
2101YA0400XAddiction (Substance Use Disorder) Counselor34001751IN
3101YM0800XMental Health Counselor34001751IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000216847OTHERANTHEM

General Provider Information

NPI Number : 1629052675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH ANN REUTTER LCSW
Provider Business Mailing Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number : 812-339-1691
Fax Number : 812-337-2438
Provider Business Practice Location Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number : 812-339-1691
Fax Number : 812-337-2438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 01/23/2015

Similar Medicare Providers

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1326022518 — LINDA K GROVE-PAUL LCSW
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1689658874 — URSULA SUE MCCORMICK CNS
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1043295694 — DR. JAMES G MARENCIK MD
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1952386500 — DEBRA SUZANNE MITCHELL LCSW
Practice Location Address:
645 S ROGERS ST
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Directions to “ DEBORAH ANN REUTTER LCSW” Practice Location

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