Provider Demographics
NPI:1508412230
Name:GUTERL, RYAN (LPC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:GUTERL
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 1:106 ROUTE 10
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1734
Mailing Address - Country:US
Mailing Address - Phone:201-456-7522
Mailing Address - Fax:
Practice Address - Street 1:106 ROUTE 10
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1734
Practice Address - Country:US
Practice Address - Phone:201-456-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004661101YP2500X
NJ37PC00601400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional