Provider Demographics
NPI:1538512868
Name:GUYTON, DEWAND (LLMSW)
Entity Type:Individual
Prefix:
First Name:DEWAND
Middle Name:
Last Name:GUYTON
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16494 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4705
Mailing Address - Country:US
Mailing Address - Phone:248-957-9163
Mailing Address - Fax:248-957-9165
Practice Address - Street 1:26105 ORCHARD LAKE RD STE 309
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4510
Practice Address - Country:US
Practice Address - Phone:248-957-9163
Practice Address - Fax:248-957-9165
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801100049104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker