Provider Demographics
NPI:1942061908
Name:NUTTER, STEVIE MARIE (CDCA, CPRS)
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:MARIE
Last Name:NUTTER
Suffix:
Gender:F
Credentials:CDCA, CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 GREAT MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8466
Mailing Address - Country:US
Mailing Address - Phone:740-589-2832
Mailing Address - Fax:
Practice Address - Street 1:233 GREAT MEADOW RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8466
Practice Address - Country:US
Practice Address - Phone:740-589-2832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH186260101YA0400X
OHAPS.005607175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)