Provider Demographics
NPI:1558526434
Name:C D GUIGNARD LLC
Entity Type:Organization
Organization Name:C D GUIGNARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GUIGNARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN MED EDS
Authorized Official - Phone:803-960-9361
Mailing Address - Street 1:4700 FOREST DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3119
Mailing Address - Country:US
Mailing Address - Phone:803-960-9361
Mailing Address - Fax:803-748-4755
Practice Address - Street 1:4700 FOREST DR
Practice Address - Street 2:SUITE 202
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-3119
Practice Address - Country:US
Practice Address - Phone:803-960-9361
Practice Address - Fax:803-748-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3635101YP2500X
SC4099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty