Provider Demographics
NPI:1659348282
Name:GUIDRY, MONICA S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:S
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 OCHO RIOS DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5585
Mailing Address - Country:US
Mailing Address - Phone:985-326-9876
Mailing Address - Fax:
Practice Address - Street 1:416 OCHO RIOS DR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5585
Practice Address - Country:US
Practice Address - Phone:853-269-8769
Practice Address - Fax:919-678-1111
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2827103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000826Medicaid