Carly Jean Gutierrez, in Hicksville, NY - Medicare Counselor Provider

Carly Jean Gutierrez, is a medicare enrolled "Counselor - Mental Health" provider in Hicksville, New York. Her current practice location is 100 W Nicholai St Unit 2, Hicksville, New York. You can reach out to her office (for appointments etc.) via phone at (516) 788-7258.

Carly Jean Gutierrez is licensed to practice in New York (license number D010069) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114415015.

Contact Information

	Carly Jean Gutierrez,
	100 W Nicholai St Unit 2, Hicksville, NY 11801-3887
	(516) 788-7258
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Carly Jean Gutierrez
Gender	Female
Speciality	Counselor - Mental Health
Location	100 W Nicholai St Unit 2, Hicksville, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114415015
Provider Enumeration Date: 04/25/2018
Last Update Date: 10/23/2025

Medicare PECOS Information:

PECOS PAC ID: 7810348042
Enrollment ID: I20240111002818

Medical Identifiers

Medical identifiers for Carly Jean Gutierrez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114415015	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	D010069 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carly Jean Gutierrez allows following entities to bill medicare on her behalf.

Entity Name	Park Slope Center For Mental Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851382188 PECOS PAC ID: 8224936455 Enrollment ID: O20031226000202

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carly Jean Gutierrez is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Carly Jean Gutierrez, 117 Dare Ct, Brooklyn, NY 11229-6386 Ph: (646) 280-6500	Carly Jean Gutierrez, 100 W Nicholai St Unit 2, Hicksville, NY 11801-3887 Ph: (516) 788-7258

Reviews and Comments

Counselor in Hicksville, NY

Latoya Williams, MHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Oyster Bay Rd, Hicksville, NY 11801 Phone: 516-822-6111
Darien Jenkins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Oyster Bay Rd, Hicksville, NY 11801 Phone: 516-822-6111
Mr. Orlando Deval Isaac, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Oyster Bay Rd, Hicksville, NY 11801 Phone: 516-822-6111
Anne G Ceant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Oyster Bay Rd, Hicksville, NY 11801 Phone: 516-434-0481
Miosotys Charlene Hernandez, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 90 Haverford Rd, Hicksville, NY 11801 Phone: 646-963-7156
Laura C Pulido, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Oyster Bay Rd, Hicksville, NY 11801 Phone: 516-660-2734
Devyn Ryan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Oyster Bay Rd, Hicksville, NY 11801 Phone: 631-471-2260

Carly Jean Gutierrez, - Medicare Counselor in Hicksville, NY