Provider Demographics
NPI:1902975766
Name:HUTSON, GWEN C (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GWEN
Middle Name:C
Last Name:HUTSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 TRINITY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-4528
Mailing Address - Country:US
Mailing Address - Phone:432-520-4207
Mailing Address - Fax:432-682-1442
Practice Address - Street 1:1030 ANDREWS HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3872
Practice Address - Country:US
Practice Address - Phone:432-889-8463
Practice Address - Fax:432-682-1442
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional