Provider Demographics
NPI:1326842998
Name:GUTIERREZ, MONICA NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:NICOLE
Last Name:GUTIERREZ
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 POWDER HORN LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-3065
Mailing Address - Country:US
Mailing Address - Phone:817-907-3574
Mailing Address - Fax:
Practice Address - Street 1:702 HUNTERS ROW CT
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4001
Practice Address - Country:US
Practice Address - Phone:817-907-3574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YS0200X
TX111503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool