Provider Demographics
NPI:1013242759
Name:GUDNITZ, DENINE MARIA (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:DENINE
Middle Name:MARIA
Last Name:GUDNITZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12060 LITTLE PATUXENT PKWY APT C
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4825
Mailing Address - Country:US
Mailing Address - Phone:301-512-9922
Mailing Address - Fax:
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6521
Practice Address - Country:US
Practice Address - Phone:301-512-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional