Provider Demographics
NPI:1477048148
Name:GURICH, ROBERT (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GURICH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 MORRISON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-7411
Mailing Address - Country:US
Mailing Address - Phone:615-430-7315
Mailing Address - Fax:
Practice Address - Street 1:1325 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:615-866-6163
Practice Address - Fax:615-905-0210
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4131OtherTEMPORARY LICENSE