Healthcare Provider Details

I. General information

NPI: 1649316084
Provider Name (Legal Business Name): ROSA MARIA GUZMAN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 RACE ST UNIT 105
HOLYOKE MA
01040-5883
US

IV. Provider business mailing address

164 RACE ST UNIT 105
HOLYOKE MA
01040-5883
US

V. Phone/Fax

Practice location:
  • Phone: 413-206-4660
  • Fax:
Mailing address:
  • Phone: 413-206-4660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1120886
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number013693
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: