MEDICARE: LYNNAE GUFFIE LMSW PLLC

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

General Provider Information

NPI Number	:	1083347397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNNAE GUFFIE LMSW PLLC

Provider Business Mailing Address
First Line	:	705 GLADSTONE DR SE
Second Line	:
City	:	EAST GRAND RAPIDS
State	:	MI
Zip	:	49506-2820
Country	:	US
Telephone Number	:	616-430-1866
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 GLADSTONE DR SE
Second Line	:
City	:	EAST GRAND RAPIDS
State	:	MI
Zip	:	49506-2820
Country	:	US
Telephone Number	:	616-430-1866
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MS. LYNNAE DAWN GUFFIE
Credential	:	LMSW
Telephone Number	:	616-430-1866

Provider Enumeration Date	:	07/05/2022
Last Update Date	:	07/05/2022

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