Provider Demographics
NPI:1245497437
Name:GUINDON, MARY H (LCPC, PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:H
Last Name:GUINDON
Suffix:
Gender:F
Credentials:LCPC, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 CLUBSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-1568
Mailing Address - Country:US
Mailing Address - Phone:443-918-8123
Mailing Address - Fax:
Practice Address - Street 1:404 CLUBSIDE DR
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-1568
Practice Address - Country:US
Practice Address - Phone:443-918-8123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1333101YM0800X
PAPS006862L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling