Provider Demographics
NPI:1184792889
Name:CUTLER, LINDA F (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:F
Last Name:CUTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:K
Other - Last Name:FRYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1 BURHANS PLACE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054
Mailing Address - Country:US
Mailing Address - Phone:518-439-4576
Mailing Address - Fax:518-439-8407
Practice Address - Street 1:1 BURHANS PLACE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054
Practice Address - Country:US
Practice Address - Phone:518-439-4576
Practice Address - Fax:518-439-4576
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR02447011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01459732Medicaid
541968Medicare ID - Type Unspecified