Provider Demographics
NPI:1447076484
Name:GUZMAN HERRERA, JOHNNY A (LMSW)
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:A
Last Name:GUZMAN HERRERA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:7211 AUSTIN ST # 102
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5354
Mailing Address - Country:US
Mailing Address - Phone:929-333-4012
Mailing Address - Fax:917-779-8516
Practice Address - Street 1:7211 AUSTIN ST # 102
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5354
Practice Address - Country:US
Practice Address - Phone:929-333-4012
Practice Address - Fax:917-779-8516
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106494104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker