Basic Information
Provider Information
NPI: 1629441720
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUINART
FirstName: SUZELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4740 N STATE ROAD 7 STE 201
Address2:  
City: LAUDERDALE LAKES
State: FL
PostalCode: 333195839
CountryCode: US
TelephoneNumber: 9544864005
FaxNumber: 9544973857
Practice Location
Address1: 1957 JACKSON ST
Address2:  
City: HOLLYWOOD
State: FL
PostalCode: 330205021
CountryCode: US
TelephoneNumber: 9549212600
FaxNumber: 9544973857
Other Information
ProviderEnumerationDate: 11/11/2015
LastUpdateDate: 04/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XMH13653FLN Behavioral Health & Social Service ProvidersCounselorMental Health
104100000XMH13653FLN Behavioral Health & Social Service ProvidersSocial Worker 
171M00000XMH13653FLN Other Service ProvidersCase Manager/Care Coordinator 
1041C0700XMH13653FLY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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