Provider Demographics
NPI:1376642470
Name:ARMENTROUT, GUDRUN BIRGITTA (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:GUDRUN
Middle Name:BIRGITTA
Last Name:ARMENTROUT
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 FORREST TRAIL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521
Mailing Address - Country:US
Mailing Address - Phone:217-424-9405
Mailing Address - Fax:
Practice Address - Street 1:247 WEST PRAIRIE
Practice Address - Street 2:CATHOLICS CHARITIES
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62523
Practice Address - Country:US
Practice Address - Phone:217-428-3458
Practice Address - Fax:217-428-4415
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist