MEDICARE: ANDREA GUTIERREZ-GLIK LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	090685	NY
2	1041C0700X	Clinical Social Worker	2021040239	MO
3	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1811416464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA GUTIERREZ-GLIK LMSW

Provider Business Mailing Address
First Line	:	225 S MERAMEC AVE
Second Line	:	APT. 310
City	:	CLAYTON
State	:	MO
Zip	:	63105
Country	:	US
Telephone Number	:	314-882-6132
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 S MERAMEC AVE
Second Line	:	APT. 310
City	:	CLAYTON
State	:	MO
Zip	:	63105
Country	:	US
Telephone Number	:	314-882-6132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	12/01/2025

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