Healthcare Provider Details

I. General information

NPI: 1831460153
Provider Name (Legal Business Name): JULIE GUYNN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S WALNUT ST STE C6
LAS CRUCES NM
88001-2617
US

IV. Provider business mailing address

151 S WALNUT ST STE C6
LAS CRUCES NM
88001-2617
US

V. Phone/Fax

Practice location:
  • Phone: 605-209-1915
  • Fax:
Mailing address:
  • Phone: 605-209-1915
  • Fax: 575-647-9063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0135151
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: