Individual
MR. BRIAN JAY GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LADC
Contact information
Practice address
7747 ASHBY GATE ST, LAS VEGAS, NV 89166-5111
(760) 272-5696
Mailing address
7747 ASHBY GATE ST, LAS VEGAS, NV 89166-5111
(760) 272-5696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01496-L
NV
101YM0800X
Mental Health Counselor
7132-C
NV
104100000X
Social Worker
7132-C
NV
1041C0700X
Clinical Social Worker
Primary
7132-C
NV
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/06/2006
Last updated
05/26/2016
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