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CARLY JEAN GUTIERREZ
NPI 1114415015
Counselor - Mental Health in Hicksville, NY

Active since April 25, 2018PECOS Enrolled
100 W NICHOLAI ST UNIT 2, HICKSVILLE, NY 11801(516) 788-7258 Get Directions Write a Review

NPPES record last updated: October 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 21, 2021, Apr 25, 2018 (2 updates tracked since 2018).

About Carly Jean Gutierrez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY JEAN GUTIERREZ (NPI 1114415015) is an individual mental health provider in Hicksville, New York, licensed in New York (D010069) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114415015
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameCARLY JEAN GUTIERREZ
Location Address100 W NICHOLAI ST UNIT 2Hicksville, NY 11801-3887
Mailing Address117 Dare CtBrooklyn, NY 11229-6386 · (646) 280-6500
Phone(516) 788-7258
Sole ProprietorNo
Enumeration DateApril 25, 2018
Last NPPES UpdateOctober 23, 20252 updates tracked since enumeration
NPPES CertifiedOctober 23, 2025
✔ NPI 1114415015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · D010069
100 W NICHOLAI ST UNIT 2, Hicksville, NY 11801
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carly Jean Gutierrez is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH AUGUST STANTON LCSW
Social Worker (Clinical)
100 W NICHOLAI ST UNIT 2
HICKSVILLE, NY 11801
Nassau County (516) 788-7258
CALLIOPE MAKRIS LMHC, LMSW
Social Worker
100 W NICHOLAI ST UNIT 2
HICKSVILLE, NY 11801
Nassau County (516) 788-5470
MIA L RASPANTI
Social Worker
100 W NICHOLAI ST UNIT 2
HICKSVILLE, NY 11801
Nassau County (561) 818-9901
LONG ISLAND TREATMENT CENTER LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
100 W NICHOLAI ST UNIT 2
HICKSVILLE, NY 11801
Nassau County (561) 818-9901
LITC BH LLC
Substance Abuse Rehabilitation Facility
100 W NICHOLAI ST UNIT 2
HICKSVILLE, NY 11801
Nassau County (561) 818-9901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Gutierrez's NPI number?

The NPI number for Carly Gutierrez is 1114415015. It was assigned to this individual provider in the NPPES registry on April 25, 2018.

Where is Carly Gutierrez located?

Carly Gutierrez practices at 100 W Nicholai St Unit 2, Hicksville, NY 11801. The listed phone number is (516) 788-7258.

What is Carly Gutierrez's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Carly Gutierrez enrolled in Medicare?

Yes. Carly Gutierrez is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carly Gutierrez was last updated on October 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.