Provider Demographics
NPI:1073948535
Name:GUILLORY, GARLAND (PHD, MA, MFT, CADC)
Entity Type:Individual
Prefix:DR
First Name:GARLAND
Middle Name:
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:PHD, MA, MFT, CADC
Other - Prefix:DR
Other - First Name:GARLAND
Other - Middle Name:
Other - Last Name:GERBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, MA, MFT, CADC
Mailing Address - Street 1:8025 ALVERSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-1436
Mailing Address - Country:US
Mailing Address - Phone:310-855-4090
Mailing Address - Fax:
Practice Address - Street 1:8025 ALVERSTONE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1436
Practice Address - Country:US
Practice Address - Phone:310-855-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPHD1744R1102X
CA130138106H00000X
CAA057130520101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)