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General NPI Number Information
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NPI Number | 1811854318
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Entity Type | Individual
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Provider Name | ELIJAH C GUTMAN
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Gender | Male
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 5426 VEGAS DR
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City | LAS VEGAS
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State | NV
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Zip | 89108-2403
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Country | US
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Telephone | 702-502-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 6348 BRANDYWINE WAY
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City | LAS VEGAS
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State | NV
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Zip | 89107-3432
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Country | US
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Telephone | 702-502-2004
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CI5662
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License Number State | NV
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