Basic Information
| Provider Information | |||||||||
| NPI: | 1538820204 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUERIN | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | AUCOIN | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 395 | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707220395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256835292 | ||||||||
| FaxNumber: | 2256831310 | ||||||||
| Practice Location | |||||||||
| Address1: | 28315 S FROST RD | ||||||||
| Address2: | |||||||||
| City: | LIVINGSTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707542612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2252831356 | ||||||||
| FaxNumber: | 2256862962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2022 | ||||||||
| LastUpdateDate: | 01/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 10162 | LA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.