Provider Demographics
NPI:1083347397
Name:LYNNAE GUFFIE LMSW PLLC
Entity Type:Organization
Organization Name:LYNNAE GUFFIE LMSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNAE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:GUFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-430-1866
Mailing Address - Street 1:705 GLADSTONE DR SE
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-2820
Mailing Address - Country:US
Mailing Address - Phone:616-430-1866
Mailing Address - Fax:
Practice Address - Street 1:705 GLADSTONE DR SE
Practice Address - Street 2:
Practice Address - City:EAST GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2820
Practice Address - Country:US
Practice Address - Phone:616-430-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty