Provider Demographics
NPI:1225852197
Name:GUIDICE, TERESA FRANCES (MHC-LP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:FRANCES
Last Name:GUIDICE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 COLDEN AVE APT 2F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-3199
Mailing Address - Country:US
Mailing Address - Phone:646-544-4286
Mailing Address - Fax:
Practice Address - Street 1:115 IRVING AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-8024
Practice Address - Country:US
Practice Address - Phone:516-468-3526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP124479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health