Provider Demographics
NPI:1508236589
Name:GAUTNEY, MONICA (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:GAUTNEY
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 MAPLEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-2904
Mailing Address - Country:US
Mailing Address - Phone:816-835-9776
Mailing Address - Fax:
Practice Address - Street 1:8098 PRECINCT LINE RD # 110
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7693
Practice Address - Country:US
Practice Address - Phone:817-778-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2816101YP2500X
TX81408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional