Active NPI
Perryn Gutkowski
- Mental Health Counselor
- Odenton, MD
National Provider Identifier
1336340546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 72072530
- Practice address
- 1202 Annapolis Rd
Suite F
Odenton, MD 21113-1387 - Phone
- (410) 672-2862
- Fax
- (410) 672-2869
- NPI assigned
- May 29, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 72072530 | NY | Primary |
Addresses
Primary practice location
1202 Annapolis Rd
Suite F
Odenton, MD 21113-1387
Mailing address
1762 Sea Pine Cir
Severn, MD 21144-1815
Phone (410) 551-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 72072530 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 72072530 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Forensic Assessments and Treatment, LLC | Mental Health | Current | Accepting new patients |
| Compass Mental Health Consultants, LLC | Mental Health | Past | Accepting new patients |
| Compass Mental Health Consultants, LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1336340546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1762 SEA PINE CIR",
"city": "SEVERN",
"state": "MD",
"postal_code": "211441815",
"telephone_number": "410-551-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 ANNAPOLIS RD",
"address_2": "SUITE F",
"city": "ODENTON",
"state": "MD",
"postal_code": "211131387",
"telephone_number": "410-672-2862",
"fax_number": "410-672-2869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTKOWSKI",
"first_name": "PERRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "72072530",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "72072530",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odenton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.