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Contact Information

SUSAN C WUTTKE, LCSW
345 MANNING ROAD
LAKEMONT, GA30552
 Phone: 706-212-0195
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for SUSAN C WUTTKE · (Female)

NPI # 1639317548
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 01/30/2009
Last updated 01/30/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # CSW004067
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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