Healthcare Provider Details

I. General information

NPI: 1306641287
Provider Name (Legal Business Name): CHLOE ANNE GUHLSTORF MA, AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2025
Last Update Date: 02/15/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 PACIFIC COAST HWY
HERMOSA BEACH CA
90254-2751
US

IV. Provider business mailing address

1212 N HARPER AVE
WEST HOLLYWOOD CA
90046-3785
US

V. Phone/Fax

Practice location:
  • Phone: 708-710-3002
  • Fax:
Mailing address:
  • Phone: 708-710-3002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number148688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: