Provider Demographics
NPI:1306878913
Name:GUTIERREZ, ALEECE (LMSW)
Entity type:Individual
Prefix:MS
First Name:ALEECE
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ALEECE
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:8404 CASPER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-9700
Mailing Address - Country:US
Mailing Address - Phone:307-237-0656
Mailing Address - Fax:307-237-0656
Practice Address - Street 1:8404 CASPER MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-9700
Practice Address - Country:US
Practice Address - Phone:307-267-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085897104100000X
WYLCSW-6901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker