Provider Demographics
NPI:1194273946
Name:GUILLET, PHILIP (MS, LCPC, NCC)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:GUILLET
Suffix:
Gender:M
Credentials:MS, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 REDFIELD RD APT L
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4697
Mailing Address - Country:US
Mailing Address - Phone:410-776-5946
Mailing Address - Fax:
Practice Address - Street 1:8415 BELLONA LN STE 203
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2066
Practice Address - Country:US
Practice Address - Phone:410-777-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional