Provider Demographics
NPI:1386172880
Name:SUTTON, ANCHETTA (LCSW)
Entity type:Individual
Prefix:
First Name:ANCHETTA
Middle Name:
Last Name:SUTTON
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 1:8597 FALLING SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-8461
Mailing Address - Country:US
Mailing Address - Phone:904-866-6961
Mailing Address - Fax:
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-677-6812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-27
Last Update Date:2017-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW143691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical