Provider Demographics
NPI:1205966215
Name:GUICH, LIGIA I
Entity type:Individual
Prefix:MS
First Name:LIGIA
Middle Name:I
Last Name:GUICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIGIA
Other - Middle Name:I
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-1728
Mailing Address - Country:US
Mailing Address - Phone:914-381-6110
Mailing Address - Fax:914-381-6964
Practice Address - Street 1:930 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1629
Practice Address - Country:US
Practice Address - Phone:914-381-6110
Practice Address - Fax:914-381-6964
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPO51320-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPO51320-1OtherNY STATE LCSW LICENSE