Provider Demographics
NPI:1578209649
Name:MISSING PIECES PSYCHOLOGY LCC
Entity Type:Organization
Organization Name:MISSING PIECES PSYCHOLOGY LCC
Other - Org Name:GUARINO PSYCHOLOGICAL, LCC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/ PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARINO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:803-731-6699
Mailing Address - Street 1:203 W MAIN ST STE G1
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2672
Mailing Address - Country:US
Mailing Address - Phone:803-731-6699
Mailing Address - Fax:
Practice Address - Street 1:203 W MAIN ST STE G1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2672
Practice Address - Country:US
Practice Address - Phone:973-390-4551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty