Provider Demographics
NPI:1619454477
Name:GUIDO, AMY GENE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GENE
Last Name:GUIDO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 E GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3617
Mailing Address - Country:US
Mailing Address - Phone:602-743-5299
Mailing Address - Fax:
Practice Address - Street 1:301 E BETHANY HOME RD STE C296
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1271
Practice Address - Country:US
Practice Address - Phone:602-743-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2681I101Y00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor