Provider Demographics
NPI:1356409254
Name:GUTTERMAN, LINDA (LCSW, OTR)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:GUTTERMAN
Suffix:
Gender:F
Credentials:LCSW, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BUIST RD
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-2078
Mailing Address - Country:US
Mailing Address - Phone:917-364-6270
Mailing Address - Fax:845-876-0652
Practice Address - Street 1:24 BUIST RD
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-2078
Practice Address - Country:US
Practice Address - Phone:917-364-6270
Practice Address - Fax:845-876-0652
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0771431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300044203Medicare PIN