Provider Demographics
NPI:1396297503
Name:KAREN L GUTHERLESS
Entity type:Organization
Organization Name:KAREN L GUTHERLESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUTHERLESS
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP CPC
Authorized Official - Phone:308-530-3622
Mailing Address - Street 1:401 W WALKER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-7837
Mailing Address - Country:US
Mailing Address - Phone:308-530-3622
Mailing Address - Fax:
Practice Address - Street 1:401 W WALKER ROAD
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101
Practice Address - Country:US
Practice Address - Phone:308-530-3622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty