Provider Demographics
NPI:1942915459
Name:GUILBOT, MAUREEN (MHC-LP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:GUILBOT
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 FLATBUSH AVE UNIT 340152
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4530
Mailing Address - Country:US
Mailing Address - Phone:347-201-0281
Mailing Address - Fax:
Practice Address - Street 1:2222 FLATBUSH AVE UNIT 340152
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4530
Practice Address - Country:US
Practice Address - Phone:347-201-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NYP132962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program