Provider Demographics
NPI:1225271992
Name:GUZMAN, LAURO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LAURO
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:14545 HERMIE LN
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-2097
Mailing Address - Country:US
Mailing Address - Phone:956-970-5441
Mailing Address - Fax:877-830-1667
Practice Address - Street 1:302 E JACKSON ST STE 102
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-970-5441
Practice Address - Fax:877-830-1667
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54345171M00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX336901901Medicaid