Provider Demographics
NPI:1760090872
Name:GUGLIELMETTI, JOSEPH PETER JR (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PETER
Last Name:GUGLIELMETTI
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OLDE FORT RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1813
Mailing Address - Country:US
Mailing Address - Phone:207-317-6192
Mailing Address - Fax:
Practice Address - Street 1:12 OLDE FORT RD
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-1813
Practice Address - Country:US
Practice Address - Phone:207-317-6192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC171031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical