Provider Demographics
NPI:1215274600
Name:RUTCHIK, KAYLEE VICTORIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:VICTORIA
Last Name:RUTCHIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KAYLEE
Other - Middle Name:VICTORIA
Other - Last Name:STIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:48 TURKEY HILL RD N
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3944
Mailing Address - Country:US
Mailing Address - Phone:858-529-5334
Mailing Address - Fax:
Practice Address - Street 1:48 TURKEY HILL RD N
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3944
Practice Address - Country:US
Practice Address - Phone:858-529-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0115741041C0700X
SC148191041C0700X
NY0841281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical