Provider Demographics
NPI:1679161905
Name:GUINOO, SHUREKA (MSW LCSWA)
Entity Type:Individual
Prefix:
First Name:SHUREKA
Middle Name:
Last Name:GUINOO
Suffix:
Gender:F
Credentials:MSW LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 HOSMER CT
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9433
Mailing Address - Country:US
Mailing Address - Phone:916-572-3764
Mailing Address - Fax:
Practice Address - Street 1:1312 HOSMER CT
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9433
Practice Address - Country:US
Practice Address - Phone:916-572-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171M00000X, 101YP2500X, 174400000X, 251B00000X, 104100000X, 251S00000X, 252Y00000X, 261QM0855X, 305S00000X, 320800000X, 347C00000X, 1041C0700X
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No174400000XOther Service ProvidersSpecialist
No251B00000XAgenciesCase Management
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No305S00000XManaged Care OrganizationsPoint of Service
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No347C00000XTransportation ServicesPrivate Vehicle