Provider Demographics
NPI:1205843794
Name:GUICE, DEENA M (MA, LLP)
Entity Type:Individual
Prefix:MS
First Name:DEENA
Middle Name:M
Last Name:GUICE
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E LINCOLN AVE
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3349
Mailing Address - Country:US
Mailing Address - Phone:313-550-0216
Mailing Address - Fax:
Practice Address - Street 1:23975 NOVI RD
Practice Address - Street 2:SUITE C-101
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2459
Practice Address - Country:US
Practice Address - Phone:313-550-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012058101YM0800X, 103T00000X, 103TA0400X, 103TC2200X
MIDG012058103T00000X
MI630102508103TC2200X, 101YM0800X, 103TA0400X
MI630102058103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent