Provider Demographics
NPI:1225372931
Name:GUIDRY, MICHELE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MARIE
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 BRAKLEY DR STE B2
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2333
Mailing Address - Country:US
Mailing Address - Phone:225-802-1323
Mailing Address - Fax:225-924-6627
Practice Address - Street 1:2924 BRAKLEY DR STE B2
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2333
Practice Address - Country:US
Practice Address - Phone:225-802-1323
Practice Address - Fax:225-924-6627
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty