Provider Demographics
NPI:1356966881
Name:GUESS, SAMANTHA (LCPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:GUESS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 ARTAIUS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5231
Mailing Address - Country:US
Mailing Address - Phone:847-461-1005
Mailing Address - Fax:
Practice Address - Street 1:1512 ARTAIUS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5231
Practice Address - Country:US
Practice Address - Phone:847-461-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health