Provider Demographics
NPI:1407407281
Name:GUERRERO, LISSETTE ROCIO (MSW, LCSWA)
Entity Type:Individual
Prefix:MISS
First Name:LISSETTE
Middle Name:ROCIO
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:MISS
Other - First Name:LISSETTE
Other - Middle Name:ROCIO
Other - Last Name:GUERRERO PALACIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1513 ECHO RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 CHAPEL HILL RD STE 23
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1186
Practice Address - Country:US
Practice Address - Phone:919-688-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP014051101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health