MEDICARE: GREGORY P GUERIN MA, LPC

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
2	101YM0800X	Mental Health Counselor	3196	LA

General Provider Information

NPI Number	:	1932488525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY P GUERIN MA, LPC

Provider Business Mailing Address
First Line	:	154 ALBANY AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2102
Country	:	US
Telephone Number	:	318-349-5590
Fax Number	:	833-851-7335

Provider Business Practice Location Address
First Line	:	154 ALBANY AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2102
Country	:	US
Telephone Number	:	318-349-5590
Fax Number	:	833-851-7335

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

Provider Enumeration Date	:	08/12/2011
Last Update Date	:	05/24/2024

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