Provider Demographics
NPI:1811349533
Name:GUFFEY, MARYGRACE (LMHC)
Entity type:Individual
Prefix:
First Name:MARYGRACE
Middle Name:
Last Name:GUFFEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:GUFFEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 121631
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34712-1631
Mailing Address - Country:US
Mailing Address - Phone:407-588-7057
Mailing Address - Fax:
Practice Address - Street 1:2530 CITRUS TOWER BLVD APT 19105
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6987
Practice Address - Country:US
Practice Address - Phone:407-588-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15221101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor