Provider Demographics
NPI:1215932199
Name:GUESS, KAREN BOOMERSHINE (LCSW, LMFT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:BOOMERSHINE
Last Name:GUESS
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 BEE CAVES RD
Mailing Address - Street 2:STE 125
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5523
Mailing Address - Country:US
Mailing Address - Phone:512-327-1759
Mailing Address - Fax:512-327-3916
Practice Address - Street 1:3103 BEE CAVES RD
Practice Address - Street 2:STE 125
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5523
Practice Address - Country:US
Practice Address - Phone:512-327-1759
Practice Address - Fax:512-327-3916
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS162901041C0700X
TX003802-006214106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist