Provider Demographics
NPI:1770749368
Name:GUARE, JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:GUARE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9444 CARLYLE DR
Mailing Address - Street 2:APT A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3909
Mailing Address - Country:US
Mailing Address - Phone:317-525-8213
Mailing Address - Fax:
Practice Address - Street 1:6625 NETWORK WAY STE 100
Practice Address - Street 2:INTECH ELEVEN
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-0007
Practice Address - Country:US
Practice Address - Phone:317-275-7010
Practice Address - Fax:317-275-7012
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-03
Last Update Date:2008-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041443A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical