MEDICARE: MRS. ASHLEY GUTIERREZ LCSW, CATP, CCTS-P

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	34010555A	IN

General Provider Information

NPI Number	:	1740791326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY GUTIERREZ LCSW, CATP, CCTS-P

Provider Business Mailing Address
First Line	:	PO BOX 2345
Second Line	:	LOT 638
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-2345
Country	:	US
Telephone Number	:	812-297-8351
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 2345
Second Line	:	LOT 638
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-2345
Country	:	US
Telephone Number	:	812-297-8351
Fax Number	:

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

Provider Enumeration Date	:	10/23/2017
Last Update Date	:	03/31/2025

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