Provider Demographics
NPI:1417720228
Name:GUZMAN, JESSICA MARIE (LMHC-D)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LMHC-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 HOKE AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2907
Mailing Address - Country:US
Mailing Address - Phone:718-200-8558
Mailing Address - Fax:
Practice Address - Street 1:227 HOKE AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2907
Practice Address - Country:US
Practice Address - Phone:718-200-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health