Healthcare Provider Details

I. General information

NPI: 1518504596
Provider Name (Legal Business Name): OFFICE OF RANDY GUINARD, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 CALIFORNIA AVENUE
LIBBY MT
59923
US

IV. Provider business mailing address

703 CALIFORNIA AVENUE
LIBBY MT
59923
US

V. Phone/Fax

Practice location:
  • Phone: 406-293-3993
  • Fax: 406-293-3990
Mailing address:
  • Phone: 406-293-3993
  • Fax: 406-293-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. SINDY FILLER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 406-293-3993