Provider Demographics
NPI:1740791326
Name:GUTIERREZ, ASHLEY (LCSW, CATP, CCTS-P)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LCSW, CATP, CCTS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3314
Mailing Address - Country:US
Mailing Address - Phone:812-297-8351
Mailing Address - Fax:
Practice Address - Street 1:205 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3314
Practice Address - Country:US
Practice Address - Phone:812-297-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty