Active NPI
Jessica Gutierrez
- Clinical Social Worker
- Katy, TX
National Provider Identifier
1356023402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 106839
- Practice address
- 20915 Kingsland Blvd
Katy, TX 77450-5548 - Phone
- (281) 579-0703
- NPI assigned
- Aug 7, 2023
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 106839 | TX | Primary |
Addresses
Primary practice location
20915 Kingsland Blvd
Katy, TX 77450-5548
Mailing address
20915 Kingsland Blvd
Katy, TX 77450-5548
Phone (281) 579-0703
Other practice location 1
10600 Southdown Trace Trl Apt 1809
Houston, TX 77034-4676
Phone (612) 743-8444
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 |
|---|---|---|---|
| 106839 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stone Creek Psychotherapy and Wellness Center | Current | Accepting new patients |
Locations
20915 Kingsland Blvd
Katy, TX 77450
Phone (281) 579-0703
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Katy, TX
- NPI 1003009978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1356023402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20915 KINGSLAND BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774505548",
"telephone_number": "281-579-0703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20915 KINGSLAND BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774505548",
"telephone_number": "281-579-0703"
}
],
"practiceLocations": [
{
"address_1": "10600 Southdown Trace Trl Apt 1809",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770344676",
"country_code": "US",
"telephone_number": "612-743-8444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-07",
"last_updated": "2023-08-07",
"certification_date": "2023-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "106839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.