Provider Demographics
NPI:1376728147
Name:GUTKNECHT, DAVID MICHAEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:GUTKNECHT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 ELIOT CIR
Mailing Address - Street 2:UNIT 203
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2496
Mailing Address - Country:US
Mailing Address - Phone:303-460-7704
Mailing Address - Fax:303-460-7704
Practice Address - Street 1:3705 W 112TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2140
Practice Address - Country:US
Practice Address - Phone:720-244-6418
Practice Address - Fax:303-460-7704
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional