Provider Demographics
NPI:1215689716
Name:CARLOS GUERRERO LICENSED CLINICAL SOCIAL WORKER, INSPIRATION POINT COU
Entity type:Organization
Organization Name:CARLOS GUERRERO LICENSED CLINICAL SOCIAL WORKER, INSPIRATION POINT COU
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-283-9522
Mailing Address - Street 1:1130 E CLARK AVE
Mailing Address - Street 2:STE 150 # 378
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-3479
Mailing Address - Country:US
Mailing Address - Phone:805-260-5619
Mailing Address - Fax:805-738-7880
Practice Address - Street 1:1414 S MILLER ST STE P
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6915
Practice Address - Country:US
Practice Address - Phone:805-283-9522
Practice Address - Fax:805-738-7880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty