Provider Demographics
NPI:1508069436
Name:GUNTER, RUSHTON (PLMHP)
Entity Type:Individual
Prefix:
First Name:RUSHTON
Middle Name:
Last Name:GUNTER
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 CUMING ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2000
Mailing Address - Country:US
Mailing Address - Phone:531-299-0220
Mailing Address - Fax:
Practice Address - Street 1:2504 MEREDITH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2327
Practice Address - Country:US
Practice Address - Phone:531-299-7465
Practice Address - Fax:531-299-2058
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE108301041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool