Active NPI
Gertrudis Alejandra Marrero, LCSW
- Mental Health Counselor
- Niceville, FL
National Provider Identifier
1851990410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- SW21625
- Practice address
- 1417 Partin Dr N Ste 1
Niceville, FL 32578-1426 - Phone
- (850) 729-0303
- Fax
- (850) 729-0305
- NPI assigned
- Oct 23, 2020
- Last updated
- Jul 13, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW21625 | FL | Primary |
Addresses
Primary practice location
1417 Partin Dr N Ste 1
Niceville, FL 32578-1426
Mailing address
1417 Partin Dr N Ste 1
Niceville, FL 32578-1426
Phone (850) 729-0303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW21625 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael McManus Associates PA | Mental Health | Current | Accepting new patients |
| Bay Area Psychological Consultants | Single Specialty | Current | Accepting new patients |
| Bayside Psychology Services, LLC | Single Specialty | Past | Accepting new patients |
Locations
1417 Partin Dr N
Ste 1
Niceville, FL 32578
Phone (850) 729-0303
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Destin, FL
- NPI 1831232180
-
- Clinical Psychologist
- Niceville, FL
- NPI 1922388909
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689206400000",
"number": "1851990410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 PARTIN DR N STE 1",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781426",
"telephone_number": "850-729-0303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 PARTIN DR N STE 1",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781426",
"telephone_number": "850-729-0303",
"fax_number": "850-729-0305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRERO",
"first_name": "GERTRUDIS",
"middle_name": "ALEJANDRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-23",
"last_updated": "2023-07-13",
"certification_date": "2023-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "SW21625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.