Provider Demographics
NPI:1902498223
Name:GUTTERSOHN, RICHARD CHARLES (LMSW)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHARLES
Last Name:GUTTERSOHN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15530 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3806
Mailing Address - Country:US
Mailing Address - Phone:248-607-0002
Mailing Address - Fax:
Practice Address - Street 1:15530 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3806
Practice Address - Country:US
Practice Address - Phone:486-070-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical