Provider Demographics
NPI:1982026134
Name:GUYETTE, JOANNA (LICSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:GUYETTE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3235
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408-3235
Mailing Address - Country:US
Mailing Address - Phone:802-598-7969
Mailing Address - Fax:802-524-6562
Practice Address - Street 1:1233 SHELBURNE RD STE C4
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7780
Practice Address - Country:US
Practice Address - Phone:802-598-7969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00992571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical