Healthcare Provider Details

I. General information

NPI: 1790465458
Provider Name (Legal Business Name): BELEN GUASCH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 S MAIN ST STE 200
ALPHARETTA GA
30009-1949
US

IV. Provider business mailing address

350 SCOTT XING
ROSWELL GA
30076-6411
US

V. Phone/Fax

Practice location:
  • Phone: 404-548-8970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: