Shalada Cristal Creecy-Gutierrez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-11808 Issued in NM

Practice address

5555 Zuni Rd SE Ste 11
Albuquerque, NM 87108-2935

Phone

(505) 777-3002

NPI assigned

Nov 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Renewnm Therapy, IncGroup PAC ID 6901243088, 5 clinicians

Practice addresses (Care Compare)

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.

• Renewnm Therapy, Inc.

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1902585169

  Clinical

  Medicare reassignment Care Compare group NPD
• Oak Street Health Physicians Group of New Mexico LLC

  • Primary Care Clinic/Center
  • Albuquerque, NM
  • NPI 1134793151

  Clinical

  Medicare reassignment NPD
• DLM Internal Medicine Inc

  • Internal Medicine Physician
  • Barboursville, WV
  • NPI 1942546361
  NPD (past)

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1336653906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740018",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740018",
            "telephone_number": "113-759-7550",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 ZUNI RD SE STE 11",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082935",
            "telephone_number": "505-777-3002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "981 Alegria Ct",
            "address_purpose": "LOCATION",
            "city": "Los Lunas",
            "state": "NM",
            "postal_code": "870318586",
            "country_code": "US",
            "telephone_number": "505-459-6438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREECY-GUTIERREZ",
        "first_name": "SHALADA",
        "middle_name": "CRISTAL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-18",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "X-10293",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Counseling & Consulting Inc.
• Creative Healing Resources LLC
• Creative Healing Studio LLC
• Creative Interactions
• Creative Work Solutions LLC
• Christopher Creel
• Clarice May Carles Cregger
• Victoria Crenshaw, CPSW
• Delesia Crespin
• Dominique Evonne Crespin

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.