Provider Demographics
NPI:1366583114
Name:GUILLEN, DEBORAH (LPC)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W CALHOUN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76501-3127
Mailing Address - Country:US
Mailing Address - Phone:254-774-8806
Mailing Address - Fax:254-774-9672
Practice Address - Street 1:200 W CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-3127
Practice Address - Country:US
Practice Address - Phone:254-774-8806
Practice Address - Fax:254-774-9672
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182056502Medicaid