Provider Demographics
NPI:1952031676
Name:GUZMAN, LUIS RICARDO (MS, LACMH, NCC)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:RICARDO
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MS, LACMH, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E ROBINO DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2245
Mailing Address - Country:US
Mailing Address - Phone:302-244-1555
Mailing Address - Fax:
Practice Address - Street 1:4550 NEW LINDEN HILL ROAD
Practice Address - Street 2:SUITE 152
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-683-1055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAC-0010346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health