Provider Demographics
NPI:1932874153
Name:GUILLORY, S JOHN JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:S
Middle Name:JOHN
Last Name:GUILLORY
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 BARBEE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5369
Mailing Address - Country:US
Mailing Address - Phone:832-533-6142
Mailing Address - Fax:
Practice Address - Street 1:2908 BARBEE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5369
Practice Address - Country:US
Practice Address - Phone:832-533-6142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX502371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical