Provider Demographics
NPI:1083929533
Name:GUERRERO, MAYRENA (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:MAYRENA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:MAYRENA
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:201 PARK AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3366
Mailing Address - Country:US
Mailing Address - Phone:413-213-2979
Mailing Address - Fax:413-304-3993
Practice Address - Street 1:201 PARK AVE STE 9
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3366
Practice Address - Country:US
Practice Address - Phone:413-213-2979
Practice Address - Fax:413-304-3993
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000010012101YM0800X
MA10012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health