Provider Demographics
NPI:1386720738
Name:GUENTHER, TEENA DENISE (PHD)
Entity type:Individual
Prefix:DR
First Name:TEENA
Middle Name:DENISE
Last Name:GUENTHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:LANESBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01237-1800
Mailing Address - Country:US
Mailing Address - Phone:413-281-2580
Mailing Address - Fax:413-499-4060
Practice Address - Street 1:10 MEADOW ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267-3243
Practice Address - Country:US
Practice Address - Phone:413-281-2580
Practice Address - Fax:413-499-4060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7665103G00000X, 103TC0700X
NC3654103G00000X, 103TC0700X
NY014535103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06535OtherBLUE CROSS BLUE SHIELD
MA32059OtherHEATH NEW ENGLAND
MA110032138AMedicaid
MA32059OtherHEATH NEW ENGLAND