Provider Demographics
NPI:1003692963
Name:GUTIERREZ, ADINA BARI (MHC-LP)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:BARI
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 7TH AVE STE 1106
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-0029
Mailing Address - Country:US
Mailing Address - Phone:646-797-4340
Mailing Address - Fax:
Practice Address - Street 1:850 7TH AVE STE 1106
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-0029
Practice Address - Country:US
Practice Address - Phone:646-797-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP124411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health