Provider Demographics
NPI:1932403045
Name:WILSON-GUZMAN, ELANNA HOPE (BA, MS, LMSW, LSW, L)
Entity Type:Individual
Prefix:MRS
First Name:ELANNA
Middle Name:HOPE
Last Name:WILSON-GUZMAN
Suffix:
Gender:F
Credentials:BA, MS, LMSW, LSW, L
Other - Prefix:MISS
Other - First Name:ELANNA
Other - Middle Name:HOPE
Other - Last Name:TOMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:7680 ROLLING MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1225
Mailing Address - Country:US
Mailing Address - Phone:702-755-1585
Mailing Address - Fax:702-755-1585
Practice Address - Street 1:401 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1922
Practice Address - Country:US
Practice Address - Phone:513-221-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8513-S101Y00000X, 101YA0400X, 101YM0800X, 171M00000X, 104100000X
OHS.2207823104100000X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8513-SOtherSOCIAL WORK LICENSE