Healthcare Provider Details

I. General information

NPI: 1235917006
Provider Name (Legal Business Name): JENNIFER GUTIERREZ MS, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER CORONA MS

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4651 SALISBURY RD STE 400
JACKSONVILLE FL
32256-6187
US

IV. Provider business mailing address

9917 NW 9TH STREET CIR APT 3
MIAMI FL
33172-5161
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone: 305-834-8296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: