Selina A Gutierrez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2301 7TH St Ste a
Las Vegas, NM 87701-4966

Phone

(505) 454-9611

Fax

(505) 454-8079

NPI assigned

Dec 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Rio Grande Alcoholism Treatment Center Incorporated

  • Substance Abuse Rehabilitation Facility
  • Taos, NM
  • NPI 1194924928
  NPD

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1639839780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PASEO DEL CANON W STE A",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716943",
            "telephone_number": "575-737-5533",
            "fax_number": "575-737-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 7TH ST STE A",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014966",
            "telephone_number": "505-454-9611",
            "fax_number": "505-454-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "SELINA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83774556",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Gutierrez
• Jaylen Gutierrez, CNP
• Jeanette S Gutierrez, LBSW
• Joseph Gutierrez, BMS
• Patrick Gutierrez
• Michael Gzaskow, MD
• Cordell K Halverson, MD
• Dorian Harris
• Lori Hartse
• Georgia Leroy Haynes, MSW

• Clinical Social Worker in Las Vegas, NM
• Providers in Las Vegas, 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 Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.