Provider Demographics
NPI:1528500162
Name:GUADA PSYCHOLOGICAL SERVICES PC
Entity type:Organization
Organization Name:GUADA PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-989-0248
Mailing Address - Street 1:1701 E WOODFIELD RD STE 905
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5137
Mailing Address - Country:US
Mailing Address - Phone:847-797-4699
Mailing Address - Fax:
Practice Address - Street 1:1701 E WOODFIELD RD STE 905
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5137
Practice Address - Country:US
Practice Address - Phone:847-797-4699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009370251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health