Provider Demographics
NPI:1679010789
Name:GUY-CUPID, GAILANN N
Entity Type:Individual
Prefix:DR
First Name:GAILANN
Middle Name:N
Last Name:GUY-CUPID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAILANN
Other - Middle Name:N
Other - Last Name:GUY-FELIX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:47 STONEY GROUND
Mailing Address - Street 2:
Mailing Address - City:FREDERIKSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00841
Mailing Address - Country:US
Mailing Address - Phone:973-280-4006
Mailing Address - Fax:
Practice Address - Street 1:5030 ANCHOR WAY STE 7
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4692
Practice Address - Country:US
Practice Address - Phone:973-280-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2-27842-1B104100000X
MI6801088991104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker