Provider Demographics
NPI:1245553726
Name:GUZMAN, CARLOS EDUARDO (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:EDUARDO
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01207-1333
Mailing Address - Country:US
Mailing Address - Phone:413-854-7697
Mailing Address - Fax:
Practice Address - Street 1:23 HIGH ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1440
Practice Address - Country:US
Practice Address - Phone:413-854-7697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1228901041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical