Active NPI
Roy J Cutter, LPC
- Professional Counselor
- Wickenburg, AZ
National Provider Identifier
1447803010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-21539
- Practice address
- 453 N Jackson St
Wickenburg, AZ 85390-4213 - Phone
- (928) 955-5513
- NPI assigned
- Jul 22, 2019
- Last updated
- Mar 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-21539 | AZ | Primary |
Addresses
Primary practice location
453 N Jackson St
Wickenburg, AZ 85390-4213
Mailing address
453 N Jackson St
Wickenburg, AZ 85390-4213
Phone (928) 955-5513
Other names 1
- Roy J Wilson III
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 15, 2025 through Mar 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-21539 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740787200000",
"number": "1447803010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 N JACKSON ST",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853904213",
"telephone_number": "928-955-5513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 N JACKSON ST",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853904213",
"telephone_number": "928-955-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUTTER",
"first_name": "ROY",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-22",
"last_updated": "2025-03-01",
"certification_date": "2025-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-21539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ROY",
"last_name": "WILSON",
"middle_name": "J",
"suffix": "III",
"code": "1",
"type": "Former Name"
}
]
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- Christopher Cook
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- Claudia L Danker, LPC
- Sandra L Derau, M.A.
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.