Provider Demographics
NPI:1720618499
Name:GOUNIAI, JACQUELIN (LPC)
Entity Type:Individual
Prefix:DR
First Name:JACQUELIN
Middle Name:
Last Name:GOUNIAI
Suffix:
Gender:F
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:PO BOX 315377
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-3277
Mailing Address - Country:US
Mailing Address - Phone:671-688-8159
Mailing Address - Fax:
Practice Address - Street 1:121 NORTH SABANA DRIVE DETCHA COURT
Practice Address - Street 2:
Practice Address - City:BARRIGADA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-688-8159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GULPC-156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional