Provider Demographics
NPI:1013186824
Name:GUNTHER, MECHELLE (LCPC)
Entity Type:Individual
Prefix:
First Name:MECHELLE
Middle Name:
Last Name:GUNTHER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MECHELLE
Other - Middle Name:RENEE
Other - Last Name:PENNOYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3693 N CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-3333
Mailing Address - Country:US
Mailing Address - Phone:410-212-8795
Mailing Address - Fax:
Practice Address - Street 1:819 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4197
Practice Address - Country:US
Practice Address - Phone:410-431-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3353101YP2500X
MDLC4019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional