1669934451 NPI number — COURTNEY GUESS COUNSELING PLLC

Table of content: (NPI 1669934451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669934451 NPI number — COURTNEY GUESS COUNSELING PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COURTNEY GUESS COUNSELING PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669934451
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3355 BEE CAVES RD STE 510
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST LAKE HILLS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78746-6682
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-730-0181
Provider Business Mailing Address Fax Number:
512-329-9477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3355 BEE CAVES RD STE 510
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST LAKE HILLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78746-6682
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-730-0181
Provider Business Practice Location Address Fax Number:
512-329-9477
Provider Enumeration Date:
04/02/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PETERSEN
Authorized Official First Name:
COURTNEY
Authorized Official Middle Name:
GUESS
Authorized Official Title or Position:
COURTNEY GUESS, LCSW
Authorized Official Telephone Number:
512-730-0181

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)