Provider Demographics
NPI:1003606062
Name:GUTKE, JENNIFER (LCPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GUTKE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12813 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2245
Mailing Address - Country:US
Mailing Address - Phone:815-822-8223
Mailing Address - Fax:
Practice Address - Street 1:28W542 BATAVIA RD
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3009
Practice Address - Country:US
Practice Address - Phone:630-393-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.017016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health