MEDICARE: LAURA M GUISE LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	39001578A	IN
2	101YM0800X	Mental Health Counselor	MH20778	FL
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	87000302A	IN

General Provider Information

NPI Number	:	1649250457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA M GUISE LMHC

Provider Business Mailing Address
First Line	:	297 OTTER TRL
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33875-6329
Country	:	US
Telephone Number	:	317-296-3279
Fax Number	:	317-300-7143

Provider Business Practice Location Address
First Line	:	297 OTTER TRL
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33875-6329
Country	:	US
Telephone Number	:	317-296-3279
Fax Number	:	317-300-7143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	04/07/2024

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Directions to “ LAURA M GUISE LMHC” Practice Location

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