Provider Demographics
NPI:1114181500
Name:HELENE SHUTE LLC
Entity type:Organization
Organization Name:HELENE SHUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SHUTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:239-848-2022
Mailing Address - Street 1:12712 ASTON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-1463
Mailing Address - Country:US
Mailing Address - Phone:239-848-2022
Mailing Address - Fax:239-936-2690
Practice Address - Street 1:5237 SUMMERLIN COMMONS BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2158
Practice Address - Country:US
Practice Address - Phone:239-849-2022
Practice Address - Fax:239-275-2203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 60631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty