Provider Demographics
NPI:1073226353
Name:GUADALUPE, ZAIDA E (LPC)
Entity Type:Individual
Prefix:
First Name:ZAIDA
Middle Name:E
Last Name:GUADALUPE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 S WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2643
Mailing Address - Country:US
Mailing Address - Phone:484-794-4966
Mailing Address - Fax:
Practice Address - Street 1:4641 POTTSVILLE PIKE STE 101B
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9707
Practice Address - Country:US
Practice Address - Phone:484-794-4966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC15109101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor