Provider Demographics
NPI:1649250457
Name:GUISE, LAURA M (LMHC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:GUISE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 OTTER TRL
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33875-6329
Mailing Address - Country:US
Mailing Address - Phone:317-296-3279
Mailing Address - Fax:317-300-7143
Practice Address - Street 1:297 OTTER TRL
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-6329
Practice Address - Country:US
Practice Address - Phone:317-296-3279
Practice Address - Fax:317-300-7143
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001578A101YM0800X
FLMH20778101YM0800X
IN87000302A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)