Provider Demographics
NPI:1558971119
Name:GUZMAN, ERICA (LADC, LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 TOWN RDG
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-6550
Mailing Address - Country:US
Mailing Address - Phone:203-908-1148
Mailing Address - Fax:
Practice Address - Street 1:7231 TOWN RDG
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-6550
Practice Address - Country:US
Practice Address - Phone:203-908-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5678101YM0800X
CT44.001381101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health