Jacqueline Marie Gutierrez, MS, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

85768 Issued in TX

Practice address

4242 Medical Dr Ste 6300
San Antonio, TX 78229-5372

Phone

(844) 824-8775

NPI assigned

Jul 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Progressive Behavioral Health, PLLC

  dba LifeStance Health

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238
  Medicare reassignment Care Compare group NPD
• Mendez Counseling Centers, PLLC

  • Mental Health Counselor
  • San Antonio, TX
  • NPI 1710626478
  Medicare reassignment NPD

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1770217457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 6300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295372",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 6300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295372",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-10",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "85768",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerardo S Gutierrez, MA, CCC-SLP
• Getzael Gutierrez, REGISTERED NURSE
• Gianna Gutierrez
• Gloria G Gutierrez, RBT
• Hannah Elizabeth Gutierrez
• Janay Latrice Gutierrez
• Janette Gutierrez, RBT
• Jaydin Ashley Gutierrez, LVN
• Jennifer Gutierrez
• Joel Gutierrez, RN

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.