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:
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:PO BOX 2345
Mailing Address - Street 2:LOT 638
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2345
Mailing Address - Country:US
Mailing Address - Phone:812-297-8351
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2345
Practice Address - Street 2:LOT 638
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46206-2345
Practice Address - Country:US
Practice Address - Phone:812-297-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010555A1041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty