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General NPI Number Information
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NPI Number | 1467746461
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Entity Type | Individual
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Provider Name | EDWARD PAUL GUYTON LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 1341 SURREY CRES
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City | NORFOLK
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State | VA
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Zip | 23508-1130
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Country | US
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Telephone | 757-440-5655
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Fax |
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Provider Business Mailing Address
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Address Line | 1341 SURREY CRES
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City | NORFOLK
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State | VA
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Zip | 23508-1130
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Country | US
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Telephone | 757-440-5655
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 037697-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12102
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006140
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License Number State | VA
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