Provider Demographics
NPI:1093842379
Name:GUINN, KATJA-LARISSA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATJA-LARISSA
Middle Name:
Last Name:GUINN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:KATJA-LARISSA
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1060
Mailing Address - Fax:210-261-1821
Practice Address - Street 1:601 N FRIO ST BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3011
Practice Address - Country:US
Practice Address - Phone:210-261-3001
Practice Address - Fax:210-731-9661
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist