Provider Demographics
NPI:1760995955
Name:GUERRIER, WALTHRIDE MARY (LMSW)
Entity Type:Individual
Prefix:
First Name:WALTHRIDE
Middle Name:MARY
Last Name:GUERRIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-31 QUEENS BLVD
Mailing Address - Street 2:UNIT 222
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-9907
Mailing Address - Country:US
Mailing Address - Phone:718-896-3400
Mailing Address - Fax:
Practice Address - Street 1:9131 QUEENS BLVD STE 222
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5511
Practice Address - Country:US
Practice Address - Phone:718-869-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0828931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical