Provider Demographics
NPI:1538683354
Name:GUESSETTO, JOHN KENNETH (MA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KENNETH
Last Name:GUESSETTO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-2200
Mailing Address - Country:US
Mailing Address - Phone:270-889-6025
Mailing Address - Fax:270-885-5257
Practice Address - Street 1:PO BOX 2200
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42241-2200
Practice Address - Country:US
Practice Address - Phone:270-889-6025
Practice Address - Fax:270-885-5257
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101693103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical