Erique Emmanuel Gutierrez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-11825 Issued in NM

Practice address

1096 Mechem Dr Ste 213
Ruidoso, NM 88345-7068

Phone

(575) 219-7542

NPI assigned

Aug 16, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Group practices

Mental Health Stop LLCGroup PAC ID 9032440474, 2 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.

• Mental Health Stop LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ruidoso, NM
  • NPI 1760032577

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1376858241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 MECHEM DR STE 213",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883457068",
            "telephone_number": "575-219-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 MECHEM DR STE 213",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883457068",
            "telephone_number": "575-219-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ERIQUE",
        "middle_name": "EMMANUEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-10317",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82478058",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Rea Green-Pritchett, RN
• Allison Green
• Delcia Maurice Gudgel, LPCC NM
• Paul S Gulbas, MD
• Hilary Anne Gunby, LMHC
• Mari Lynn Scarlett Gutierrez, LCSW
• Anatole Frank Gutowski
• David Alan Gutowski, OD
• Christie Haase
• Lora Sue Hanson, CSW

• Clinical Social Worker in Ruidoso, NM
• Providers in Ruidoso, 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 Jul 20, 2021; 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.