Provider Demographics
NPI:1639725765
Name:GU, LUCY LING (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:LING
Last Name:GU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOPKINS CT
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3054
Mailing Address - Country:US
Mailing Address - Phone:215-939-5573
Mailing Address - Fax:
Practice Address - Street 1:9 HOPKINS CT
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3054
Practice Address - Country:US
Practice Address - Phone:401-294-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical