Healthcare Provider Details

I. General information

NPI: 1891590550
Provider Name (Legal Business Name): VENA MARIE GUZMAN MSW,LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 WYOMING AVE
KINGSTON PA
18704-3721
US

IV. Provider business mailing address

1105 PARKVIEW LN
DRUMS PA
18222-2302
US

V. Phone/Fax

Practice location:
  • Phone: 570-552-3760
  • Fax:
Mailing address:
  • Phone: 267-742-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW137847
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: