Provider Demographics
NPI:1104962117
Name:GUZZY, NICHOLE E (MSED, PCC - SUPV)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:E
Last Name:GUZZY
Suffix:
Gender:F
Credentials:MSED, PCC - SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 S SCHENLEY AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-2108
Mailing Address - Country:US
Mailing Address - Phone:330-518-2524
Mailing Address - Fax:
Practice Address - Street 1:8544 HICKORY HILL DR STE 5
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-5262
Practice Address - Country:US
Practice Address - Phone:330-259-0426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0008400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional