Healthcare Provider Details

I. General information

NPI: 1558975722
Provider Name (Legal Business Name): JULIANA GUERIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SOCORRO ST
LAS VEGAS NM
87701-3353
US

IV. Provider business mailing address

509 LUGAR DEL PARAISO
LAS VEGAS NM
87701-3297
US

V. Phone/Fax

Practice location:
  • Phone: 505-429-4041
  • Fax:
Mailing address:
  • Phone: 505-429-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-1061
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: