Provider Demographics
NPI:1952189839
Name:GONZALEZ-GUERRA, DIANNA HELEN (LMHC)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:HELEN
Last Name:GONZALEZ-GUERRA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 TIERRA VERDE WAY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-2664
Mailing Address - Country:US
Mailing Address - Phone:941-780-3537
Mailing Address - Fax:
Practice Address - Street 1:157 TIERRA VERDE WAY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-2664
Practice Address - Country:US
Practice Address - Phone:941-780-3537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004312101YP2500X
FLMH21812101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional