Provider Demographics
NPI:1528141801
Name:GUERARD, TERESA RAE (LMHC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:RAE
Last Name:GUERARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1571 PINE CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1574
Mailing Address - Country:US
Mailing Address - Phone:407-814-9060
Mailing Address - Fax:
Practice Address - Street 1:427 CENTER POINTE CIR
Practice Address - Street 2:SUITE 1878
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3463
Practice Address - Country:US
Practice Address - Phone:407-260-0031
Practice Address - Fax:407-260-0091
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8116211Medicaid
FL7644337Medicaid