Juan J Gutierrez, MSW,LISW
Individual provider Active NPI Clinical Social Worker · Isleta, NM
NPI 1548342686 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1548342686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I-1552 (NM)
- Practice address
- 01 Sagebrush
Isleta, NM 87022-0000 - Phone
- (505) 869-4863
- Fax
- (505) 869-4881
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-1552 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-1552 | NM | Yes |
Addresses
Primary practice location
01 Sagebrush
Isleta, NM 87022-0000
Mailing address
PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-4863
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I-1552 | Other | NM | LICENSE |
Other providers in Isleta, NM
- Lois Coomer
- Annie Felicia Coots
- Charlene Nicolette Gabaldon
- Roseann Garcia
- Devin Kyle Giron
- Nancy M Halonen
- Merel Hancock
- Leslie J Herman
- Jon Hernandez
- Stephen Hubbert
All providers in Isleta, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.