Active NPI
Jaisy Gutierrez
- Clinical Social Worker
- West Palm Beach, FL
National Provider Identifier
1750828851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW 10771
- Practice address
- 3333 Forest Hill Blvd
West Palm Beach, FL 33406-5812 - Phone
- (561) 318-4236
- Fax
- (561) 721-2809
- NPI assigned
- Jan 26, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | ISW 10771 | FL | Primary |
Addresses
Primary practice location
3333 Forest Hill Blvd
West Palm Beach, FL 33406-5812
Mailing address
129 Barcelona Dr
Royal Palm Beach, FL 33411-1314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 12, 2024 through Mar 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW 10771 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Journey2Healing, Inc. | Clinical | Current | Accepting new patients |
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.
-
- Clinical Social Worker
- Wellington, FL
- NPI 1578274528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1750828851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 BARCELONA DR",
"city": "ROYAL PALM BEACH",
"state": "FL",
"postal_code": "334111314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 FOREST HILL BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334065812",
"telephone_number": "561-318-4236",
"fax_number": "561-721-2809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "JAISY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-26",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW 10771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.