Healthcare Provider Details

I. General information

NPI: 1629914270
Provider Name (Legal Business Name): ZACHARY GUILLAUME LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 W 5TH ST
GREELEY CO
80634-5525
US

IV. Provider business mailing address

3126 W 5TH ST
GREELEY CO
80634-5525
US

V. Phone/Fax

Practice location:
  • Phone: 714-875-9644
  • Fax:
Mailing address:
  • Phone: 714-875-9644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0023296
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: