Provider Demographics
NPI:1629299888
Name:GUINN, JAMES ANTHONY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:GUINN
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CIRCLE DR
Mailing Address - Street 2:STE 2307
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76119-8134
Mailing Address - Country:US
Mailing Address - Phone:817-349-8787
Mailing Address - Fax:817-231-0605
Practice Address - Street 1:2300 CIRCLE DR
Practice Address - Street 2:STE 2307
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-8134
Practice Address - Country:US
Practice Address - Phone:817-349-8787
Practice Address - Fax:817-231-0650
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9316101YM0800X, 101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176244503Medicaid
TX176244502Medicaid
TX176244503Medicaid
TX209881602Medicaid
TX176244502Medicaid