Provider Demographics
NPI:1588557276
Name:CUTBIRTH, ELIZABETH MARIA
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIA
Last Name:CUTBIRTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15778 LAWRENCE 2130
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712-8409
Mailing Address - Country:US
Mailing Address - Phone:615-878-8634
Mailing Address - Fax:
Practice Address - Street 1:3901 W FINANCIAL PKWY
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1471
Practice Address - Country:US
Practice Address - Phone:479-986-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023050853101Y00000X
ARA2412010101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor