Provider Demographics
NPI:1740611748
Name:GUT, ANNA (CNS, PMH-BC, APRN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GUT
Suffix:
Gender:F
Credentials:CNS, PMH-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4857
Mailing Address - Country:US
Mailing Address - Phone:860-810-2302
Mailing Address - Fax:860-342-4301
Practice Address - Street 1:502 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4857
Practice Address - Country:US
Practice Address - Phone:860-810-2302
Practice Address - Fax:203-349-2087
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001319251S00000X, 364SP0807X, 364SP0811X, 364SP0813X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No251S00000XAgenciesCommunity/Behavioral Health
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No364SP0811XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Chronically Ill
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Geropsychiatric