Provider Demographics
NPI:1447803010
Name:CUTTER, ROY J (LPC)
Entity type:Individual
Prefix:MR
First Name:ROY
Middle Name:J
Last Name:CUTTER
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:ROY
Other - Middle Name:J
Other - Last Name:WILSON
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:453 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-4213
Mailing Address - Country:US
Mailing Address - Phone:928-955-5513
Mailing Address - Fax:
Practice Address - Street 1:453 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-4213
Practice Address - Country:US
Practice Address - Phone:928-955-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21539101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional