Healthcare Provider Details

I. General information

NPI: 1609787662
Provider Name (Legal Business Name): DIANA GUTIERREZ MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 PATTERSON RD
GRAND JUNCTION CO
81505-1438
US

IV. Provider business mailing address

2030 FLORA CT
GRAND JUNCTION CO
81501-6914
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-6601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0023809
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: