Provider Demographics
NPI:1124269436
Name:MCCUTCHEON, DEBORAH ANN (LCSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W F ST
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-3734
Mailing Address - Country:US
Mailing Address - Phone:209-481-5901
Mailing Address - Fax:209-848-8825
Practice Address - Street 1:603 W F ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-3734
Practice Address - Country:US
Practice Address - Phone:209-481-5901
Practice Address - Fax:209-848-8825
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical