MEDICARE: GUERIN COUNSELING, LLC

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	101YP2500X	Professional Counselor	3196	LA

General Provider Information

NPI Number	:	1912457342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUERIN COUNSELING, LLC

Provider Business Mailing Address
First Line	:	4440 VIKING DR
Second Line	:	SUITE 300
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-7511
Country	:	US
Telephone Number	:	318-349-5590
Fax Number	:	318-797-7132

Provider Business Practice Location Address
First Line	:	4440 VIKING DR
Second Line	:	SUITE 300
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-7511
Country	:	US
Telephone Number	:	318-349-5590
Fax Number	:	318-797-7132

Authorized Official
Title or Position	:	OWNER
Name	:	GREGORY GUERIN
Credential	:	LPC
Telephone Number	:	318-393-4386

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	10/10/2016

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