Provider Demographics
NPI:1235787375
Name:GUERRA, SAMANTHA FAITH (LCPC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:FAITH
Last Name:GUERRA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2411
Mailing Address - Country:US
Mailing Address - Phone:207-283-7660
Mailing Address - Fax:207-283-7664
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2411
Practice Address - Country:US
Practice Address - Phone:207-286-7660
Practice Address - Fax:207-283-7664
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC6843101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor