Provider Demographics
NPI:1689392060
Name:COMPETELLO-GUEST, KATIE M (LPC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:M
Last Name:COMPETELLO-GUEST
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 1:550 GOSHEN RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-2405
Mailing Address - Country:US
Mailing Address - Phone:860-567-9423
Mailing Address - Fax:
Practice Address - Street 1:550 GOSHEN RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2405
Practice Address - Country:US
Practice Address - Phone:860-567-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.005705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty