Provider Demographics
NPI:1932488525
Name:GUERIN, GREGORY P (MA, LPC)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:P
Last Name:GUERIN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2102
Mailing Address - Country:US
Mailing Address - Phone:318-349-5590
Mailing Address - Fax:833-851-7335
Practice Address - Street 1:154 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2102
Practice Address - Country:US
Practice Address - Phone:318-349-5590
Practice Address - Fax:833-851-7335
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3196101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional