Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Kellye Gautier, LPC

Individual provider Marriage & Family Therapist · NPI 1104272616

Mrs. Kellye Gautier, LPC is a Mental Health Counselor in Bentonville, Arkansas. Qualified in 2014, 12 years ago. Accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
12
Licensed in
AR
In the registry since
2016
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

2003 SE Walton Blvd
Bentonville, AR 72712-3725
Phone: (479) 725-6000
Fax: (479) 750-4843
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence P1810135 (AR)
Marriage & Family Therapist Taxonomy 106H00000X · Licence F1411018 (AR)

Record details

NPI number1104272616
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedMay 13, 2016
Last updated in NPPESOctober 17, 2018
Mailing address2400 S 48th St, Springdale, AR 72762-6683

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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