Provider Demographics
NPI:1316138456
Name:CUTRONA, JENNIFER D (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:CUTRONA
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 1:2110 DUNCAN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4602
Mailing Address - Country:US
Mailing Address - Phone:302-999-1106
Mailing Address - Fax:302-999-1753
Practice Address - Street 1:2110 DUNCAN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4602
Practice Address - Country:US
Practice Address - Phone:302-999-1106
Practice Address - Fax:302-999-1753
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ10000724101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE174428OtherCOMPSYCH
DE37761OtherCIGNA
DEA066181OtherVALUE OPTIONS
DE0602528OtherAETNA
DE159139OtherBLUE CROSS BLUE SHIELD DE