Provider Demographics
NPI:1669580593
Name:GUAY, MARY THERESA (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:THERESA
Last Name:GUAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17220 127TH PL NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7965
Mailing Address - Country:US
Mailing Address - Phone:425-481-4613
Mailing Address - Fax:425-481-9708
Practice Address - Street 1:17220 127TH PL NE
Practice Address - Street 2:SUITE 300
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7965
Practice Address - Country:US
Practice Address - Phone:425-481-4613
Practice Address - Fax:425-481-9708
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001742101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health