Provider Demographics
NPI:1467746461
Name:GUYTON, EDWARD PAUL (LCSW)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:PAUL
Last Name:GUYTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 SURREY CRES
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-1130
Mailing Address - Country:US
Mailing Address - Phone:757-440-5655
Mailing Address - Fax:
Practice Address - Street 1:1341 SURREY CRES
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-1130
Practice Address - Country:US
Practice Address - Phone:757-440-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037697-1104100000X
MN12102104100000X
VA09040061401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker