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NPI Code Detail

MEDICARE: AMANDA HAIDE GUTIERREZ M.ED, LPC, LCDC

MEDICARE: AMANDA HAIDE GUTIERREZ M.ED, LPC, LCDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor93647TX

General Provider Information

NPI Number : 1578498937
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA HAIDE GUTIERREZ M.ED, LPC, LCDC
Provider Business Mailing Address
First Line : 8054 EXCHANGE DR APT 915
Second Line :
City : AUSTIN
State : TX
Zip : 78754-4758
Country : US
Telephone Number : 956-455-1831
Fax Number : 956-455-1831
Provider Business Practice Location Address
First Line : 2021 GUADALUPE ST STE 260
Second Line :
City : AUSTIN
State : TX
Zip : 78705-5654
Country : US
Telephone Number : 646-941-7645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ AMANDA HAIDE GUTIERREZ M.ED, LPC, LCDC” Practice Location

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