Individual provider Active NPI

Elizabeth Amy Johnson-Gutierrez, L.M.H.C

  • Mental Health Counselor
  • Boca Raton, FL
National Provider Identifier
1083017933
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 12793 Issued in FL
Practice address
2201 NW Corporate Blvd
Suite 202
Boca Raton, FL 33431-7337
Phone
(561) 499-6932
Fax
(561) 235-5172
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 12793 FL Primary

Addresses

Primary practice location

2201 NW Corporate Blvd
Suite 202
Boca Raton, FL 33431-7337

Mailing address

2201 NW Corporate Blvd
Suite 202
Boca Raton, FL 33431-7337
Phone (561) 499-6932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH 12793FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1083017933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 NW CORPORATE BLVD",
            "address_2": "SUITE 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317337",
            "telephone_number": "561-499-6932",
            "fax_number": "561-235-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 NW CORPORATE BLVD",
            "address_2": "SUITE 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317337",
            "telephone_number": "561-499-6932",
            "fax_number": "561-235-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-GUTIERREZ",
        "first_name": "ELIZABETH",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "L.M.H.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 12793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.