Provider Demographics
NPI:1003341025
Name:GUTIERREZ, NEHEMIAH RAY (LPC)
Entity Type:Individual
Prefix:MR
First Name:NEHEMIAH
Middle Name:RAY
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:NEHEMIAS
Other - Middle Name:RAY
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCDC, LPC
Mailing Address - Street 1:PO BOX 152331
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78715-2331
Mailing Address - Country:US
Mailing Address - Phone:210-704-7573
Mailing Address - Fax:512-703-1394
Practice Address - Street 1:1700 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8962
Practice Address - Country:US
Practice Address - Phone:512-445-7700
Practice Address - Fax:512-703-1394
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional