Provider Demographics
NPI:1720415367
Name:GUTIERREZ, FRANCISCO J (MA, LCPC, CADC)
Entity Type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:J
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:MA, LCPC, CADC
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6616 ELFREDA RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-7709
Mailing Address - Country:US
Mailing Address - Phone:708-807-0184
Mailing Address - Fax:
Practice Address - Street 1:4801 W PETERSON AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646
Practice Address - Country:US
Practice Address - Phone:708-807-0184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009342101YP2500X
IL31141101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)