Healthcare Provider Details

I. General information

NPI: 1912457342
Provider Name (Legal Business Name): GUERIN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 VIKING DR SUITE 300
BOSSIER CITY LA
71111-7511
US

IV. Provider business mailing address

4440 VIKING DR SUITE 300
BOSSIER CITY LA
71111-7511
US

V. Phone/Fax

Practice location:
  • Phone: 318-349-5590
  • Fax: 318-797-7132
Mailing address:
  • Phone: 318-349-5590
  • Fax: 318-797-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3196
License Number StateLA

VIII. Authorized Official

Name: GREGORY GUERIN
Title or Position: OWNER
Credential: LPC
Phone: 318-393-4386