Provider Demographics
NPI:1851388946
Name:GUCKES, DAVID G (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:G
Last Name:GUCKES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 QUAILS HILL CT
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2037
Mailing Address - Country:US
Mailing Address - Phone:314-239-1094
Mailing Address - Fax:636-527-3564
Practice Address - Street 1:300 OZARK TRAIL DR
Practice Address - Street 2:SUITE 226
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2166
Practice Address - Country:US
Practice Address - Phone:314-239-1094
Practice Address - Fax:636-527-3564
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000425101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor