Healthcare Provider Details
I. General information
NPI: 1073948535
Provider Name (Legal Business Name): GARLAND GUILLORY PHD, MA, MFT, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/03/2013
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8025 ALVERSTONE AVE
LOS ANGELES CA
90045-1436
US
IV. Provider business mailing address
8025 ALVERSTONE AVE
LOS ANGELES CA
90045-1436
US
V. Phone/Fax
- Phone: 310-855-4090
- Fax:
- Phone: 310-855-4090
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1744R1102X |
| Taxonomy | Research Study Specialist |
| License Number | PHD |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 130138 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | A057130520 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: