Provider Demographics
NPI:1952549529
Name:SMITHS STATION AND PHENIX CITY PSYCHOLOGICAL
Entity Type:Organization
Organization Name:SMITHS STATION AND PHENIX CITY PSYCHOLOGICAL
Other - Org Name:PAUL R GUINANE PHD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RODNEY
Authorized Official - Last Name:GUINANE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:334-577-4978
Mailing Address - Street 1:475 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6464
Mailing Address - Country:US
Mailing Address - Phone:334-577-4978
Mailing Address - Fax:334-408-4518
Practice Address - Street 1:2061LEE ROAD 430
Practice Address - Street 2:
Practice Address - City:SMITHS STATION
Practice Address - State:AL
Practice Address - Zip Code:36877-2307
Practice Address - Country:US
Practice Address - Phone:334-577-4978
Practice Address - Fax:334-408-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1445103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1952549529OtherTYPE II NPI
GA1134210743OtherTYPE I NPI
AL118063Medicaid