Provider Demographics
NPI:1861248403
Name:HUTTON, DORINELL CHRISTINE (LCSWA)
Entity type:Individual
Prefix:
First Name:DORINELL
Middle Name:CHRISTINE
Last Name:HUTTON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:DORINELL
Other - Middle Name:CHRISTINE
Other - Last Name:ALCANTARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:194 BARIUM SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-8453
Mailing Address - Country:US
Mailing Address - Phone:704-832-2200
Mailing Address - Fax:
Practice Address - Street 1:209 BARIUM SPRINGS DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-8454
Practice Address - Country:US
Practice Address - Phone:704-832-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0183451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical