Provider Demographics
NPI:1699977827
Name:GUYTON-THOMPSON, TONYA ANN (LCPC, LPC, NCC, CET)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:ANN
Last Name:GUYTON-THOMPSON
Suffix:
Gender:F
Credentials:LCPC, LPC, NCC, CET
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:ANN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, LPC, NCC, CET
Mailing Address - Street 1:PO BOX 1114
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-1114
Mailing Address - Country:US
Mailing Address - Phone:207-361-7069
Mailing Address - Fax:
Practice Address - Street 1:145 NEWBURY ST. 2ND FLOOR
Practice Address - Street 2:SUITE 2
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101
Practice Address - Country:US
Practice Address - Phone:207-361-7069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC837101YA0400X
AZ11966101YP2500X
NC3574101YP2500X
MEC4773101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)