Provider Demographics
NPI:1851020200
Name:GUSCOT, DESMOND LLOYD
Entity Type:Individual
Prefix:MR
First Name:DESMOND
Middle Name:LLOYD
Last Name:GUSCOT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 E PARK ROW DR APT 214
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-3705
Mailing Address - Country:US
Mailing Address - Phone:469-875-9691
Mailing Address - Fax:
Practice Address - Street 1:3103 E PARK ROW DR APT 214
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-3705
Practice Address - Country:US
Practice Address - Phone:469-875-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82849101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional