MEDICARE: MRS. DEBORAH LORENE GUTIERREZ BA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACC.0997384	CO
2	101YP2500X	Professional Counselor	LPC.0006443	CO

General Provider Information

NPI Number	:	1629100763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH LORENE GUTIERREZ BA

Provider Business Mailing Address
First Line	:	7523 S OGDEN WAY
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-3050
Country	:	US
Telephone Number	:	303-795-5442
Fax Number	:

Provider Business Practice Location Address
First Line	:	3844 W PRINCETON CIR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80236-3111
Country	:	US
Telephone Number	:	720-734-5087
Fax Number	:	303-734-5087

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	12/15/2023

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