Provider Demographics
NPI:1043551765
Name:GUARINO, DEBRA D (LADC/CCS)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:D
Last Name:GUARINO
Suffix:
Gender:F
Credentials:LADC/CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 ROSS RD
Mailing Address - Street 2:
Mailing Address - City:OLD ORCHARD BEACH
Mailing Address - State:ME
Mailing Address - Zip Code:04064-1197
Mailing Address - Country:US
Mailing Address - Phone:207-710-1644
Mailing Address - Fax:
Practice Address - Street 1:156 ROSS RD
Practice Address - Street 2:
Practice Address - City:OLD ORCHARD BEACH
Practice Address - State:ME
Practice Address - Zip Code:04064-1197
Practice Address - Country:US
Practice Address - Phone:207-710-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC575101YA0400X
MECCS2836101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)