Provider Demographics
NPI:1740669720
Name:GUILLEN, RENE (LPC)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:GUILLEN
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 1:4504 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3712
Mailing Address - Country:US
Mailing Address - Phone:956-407-5420
Mailing Address - Fax:
Practice Address - Street 1:220 N ALTON BLVD STE C
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573-1543
Practice Address - Country:US
Practice Address - Phone:956-407-5420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-24
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional