Healthcare Provider Details

I. General information

NPI: 1013539204
Provider Name (Legal Business Name): GUANYU WANG PH.D., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15512 ROSE MEADOW DR
BATON ROUGE LA
70817-4016
US

IV. Provider business mailing address

15512 ROSE MEADOW DR
BATON ROUGE LA
70817-4016
US

V. Phone/Fax

Practice location:
  • Phone: 206-953-6806
  • Fax:
Mailing address:
  • Phone: 206-953-6806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number010664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: