Provider Demographics
NPI:1285983635
Name:CONROY, GUISELLA PAOLA (LCSW)
Entity type:Individual
Prefix:
First Name:GUISELLA
Middle Name:PAOLA
Last Name:CONROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13305 PENN ST STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1796
Mailing Address - Country:US
Mailing Address - Phone:562-551-2630
Mailing Address - Fax:
Practice Address - Street 1:13305 PENN ST STE 140
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1796
Practice Address - Country:US
Practice Address - Phone:562-551-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALCSW991701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA99170OtherBBS