Provider Demographics
NPI:1962987016
Name:CUTTINO, GRACE TILTON (LICSW)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:TILTON
Last Name:CUTTINO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-0683
Mailing Address - Country:US
Mailing Address - Phone:978-505-8053
Mailing Address - Fax:
Practice Address - Street 1:400 CONCORD ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741-1584
Practice Address - Country:US
Practice Address - Phone:978-505-8053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10230451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical