Provider Demographics
NPI:1114088374
Name:GUZAN, STANLEY JAMES (LCSW)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:JAMES
Last Name:GUZAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:STAN
Other - Middle Name:
Other - Last Name:GUZAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:120 N VAL VISTA DR
Mailing Address - Street 2:122
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-8625
Mailing Address - Country:US
Mailing Address - Phone:480-890-1947
Mailing Address - Fax:480-835-5232
Practice Address - Street 1:4554 E INVERNESS AVE
Practice Address - Street 2:SUITE 134
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4639
Practice Address - Country:US
Practice Address - Phone:480-503-2941
Practice Address - Fax:480-835-5232
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 1181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health