Provider Demographics
NPI:1629571567
Name:GUTHRIE, RASHAWN (CASAC)
Entity type:Individual
Prefix:MR
First Name:RASHAWN
Middle Name:
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-3436
Mailing Address - Country:US
Mailing Address - Phone:347-547-3626
Mailing Address - Fax:718-295-2990
Practice Address - Street 1:249 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3436
Practice Address - Country:US
Practice Address - Phone:347-547-3626
Practice Address - Fax:347-295-2990
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY48040Medicaid