Provider Demographics
NPI:1639587520
Name:TAIJERON, DOLORES M (LPC)
Entity Type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:M
Last Name:TAIJERON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UOG STATION
Mailing Address - Street 2:UNIVERSITY OF GUAM, EM&SS
Mailing Address - City:MANGILAO
Mailing Address - State:GU
Mailing Address - Zip Code:96923
Mailing Address - Country:US
Mailing Address - Phone:671-735-2292
Mailing Address - Fax:671-646-5601
Practice Address - Street 1:UOG STATION
Practice Address - Street 2:UNIVERSITY OF GUAM
Practice Address - City:MANGILAO
Practice Address - State:GU
Practice Address - Zip Code:96923
Practice Address - Country:US
Practice Address - Phone:671-735-2292
Practice Address - Fax:671-646-5601
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GULPC-016101Y00000X, 101YM0800X
GUIMF-116101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)