MEDICARE: HOLLY GUESS LPC

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	101YP2500X	Professional Counselor	5400	LA

General Provider Information

NPI Number	:	1831593995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY GUESS LPC

Provider Business Mailing Address
First Line	:	1651 THIBODEAUX AVE STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8271
Country	:	US
Telephone Number	:	225-926-4009
Fax Number	:	225-926-4069

Provider Business Practice Location Address
First Line	:	1651 THIBODEAUX AVE STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8271
Country	:	US
Telephone Number	:	225-926-4009
Fax Number	:	225-926-4069

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

Provider Enumeration Date	:	10/18/2014
Last Update Date	:	03/27/2022

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Directions to “ HOLLY GUESS LPC” Practice Location

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