Individual provider · Type 1 NPI

Carla R. Gutierrez Dominguez, LCSW

Clinical Social Worker · Waukegan, IL

NPI number 1104289867 Active

Practice location

671 S Lewis Ave
Waukegan, IL 60085-6101

Call (847) 782-4156 Map

Fax (847) 782-1030

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149.018983 (IL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104289867

Carla R. Gutierrez Dominguez, LCSW's National Provider Identifier is 1104289867, issued on Mar 31, 2016. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Waukegan, IL. The record was last updated on Jan 3, 2017.