Provider Demographics
NPI:1073143418
Name:GUYNN, DELLA M (LPCC)
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:M
Last Name:GUYNN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BURLINGTON LN STE 5
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8444
Mailing Address - Country:US
Mailing Address - Phone:502-209-7817
Mailing Address - Fax:
Practice Address - Street 1:1030 BURLINGTON LN STE 5
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-8444
Practice Address - Country:US
Practice Address - Phone:502-209-7817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261659101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional