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General NPI Number Information
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NPI Number | 1538374277
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Entity Type | Individual
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Provider Name | ANTHONY J GAUTHIER MS LMHP
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2121 N WEBB RD SUITE 310
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City | GRAND ISLAND
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State | NE
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Zip | 68803-1751
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Country | US
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Telephone | 308-385-0113
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Fax |
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Provider Business Mailing Address
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Address Line | 816 7TH ST P O BOX 65
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City | SAINT PAUL
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State | NE
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Zip | 68873-1611
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Country | US
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Telephone | 308-754-5637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 024
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 636
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License Number State | NE
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