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Individual

KRYSTYN M GUNTHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 957-2100
Mailing address
3403 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 957-2000

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
149017582
IL
1041C0700X
Clinical Social Worker
Primary
34010432A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149017582
ILLINOIS LIC
IL
05
300082132
IN
Enumeration date
06/08/2016
Last updated
05/03/2024
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