Provider Demographics
NPI:1164628715
Name:GUTOWSKI, JULIA DAWN (LMHC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:DAWN
Last Name:GUTOWSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1353
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-8353
Mailing Address - Country:US
Mailing Address - Phone:716-816-6462
Mailing Address - Fax:
Practice Address - Street 1:252 CENTER RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1947
Practice Address - Country:US
Practice Address - Phone:716-816-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20085101YA0400X
NY004203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)