Carly Jean Gutierrez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

D010069 Issued in NY

Practice address

100 W Nicholai St Unit 2
Hicksville, NY 11801-3887

Phone

(516) 788-7258

NPI assigned

Apr 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Park Slope Center for Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1851382188
  Medicare reassignment NPD
• Litc BH LLC

  • Substance Abuse Rehabilitation Facility
  • Hicksville, NY
  • NPI 1871202622
  NPD
• Long Island Treatment Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hicksville, NY
  • NPI 1770162588
  NPD

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1114415015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 DARE CT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112296386",
            "telephone_number": "646-280-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W NICHOLAI ST UNIT 2",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013887",
            "telephone_number": "516-788-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "CARLY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "D010069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherice Gude
• Mariana Michel Guercio, LCSW
• Victoria Anne Guercio, LMFT
• Jorge Alberto Guerra, DPT
• Jessica Elvira Guillen
• Reinaldo M Gutierrez Jr., M.D.
• Bernard Guzman, C.P.
• Heidi Hacsi
• Zulekha Khanam Hai, R.PH
• Lily Anne Hain

• Mental Health Counselor in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.