Provider Demographics
NPI:1336602366
Name:CONSUELO M GUTIEREZ, LCSW DBA:HEALING BALANCE THERAPY, PLLC
Entity Type:Organization
Organization Name:CONSUELO M GUTIEREZ, LCSW DBA:HEALING BALANCE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSUELO
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUTIEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-890-4016
Mailing Address - Street 1:304 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-5923
Mailing Address - Country:US
Mailing Address - Phone:406-890-4016
Mailing Address - Fax:406-245-2441
Practice Address - Street 1:304 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-5923
Practice Address - Country:US
Practice Address - Phone:406-890-4016
Practice Address - Fax:406-245-2441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty