Provider Demographics
NPI:1972648210
Name:GUIDRY, WILL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILL
Middle Name:
Last Name:GUIDRY
Suffix:
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 1:111 E SAINT PETER ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-3736
Mailing Address - Country:US
Mailing Address - Phone:337-560-1542
Mailing Address - Fax:337-369-3917
Practice Address - Street 1:111 E SAINT PETER ST
Practice Address - Street 2:SUITE E
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-3736
Practice Address - Country:US
Practice Address - Phone:337-560-1542
Practice Address - Fax:337-369-3917
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical