MEDICARE: SHUREKA GUINOO MSW LCSW

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	305S00000X	Point of Service
2	251S00000X	Community/Behavioral Health Agency
3	1041C0700X	Clinical Social Worker	0904017103	VA
4	1041C0700X	Clinical Social Worker	C016580	NC
5	171M00000X	Case Manager/Care Coordinator
6	320800000X	Mental Illness Community Based Residential Treatment Facility
7	252Y00000X	Early Intervention Provider Agency
8	101YP2500X	Professional Counselor
9	347C00000X	Private Vehicle
10	104100000X	Social Worker
11	101Y00000X	Counselor
12	101YM0800X	Mental Health Counselor		NC
13	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1679161905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUREKA GUINOO MSW LCSW

Provider Business Mailing Address
First Line	:	1312 HOSMER CT
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9433
Country	:	US
Telephone Number	:	919-438-1095
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 HOSMER CT
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9433
Country	:	US
Telephone Number	:	919-438-1095
Fax Number	:

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

Provider Enumeration Date	:	01/03/2021
Last Update Date	:	03/23/2026

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