Marcio Guzman

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

2013005503 Issued in MO

Legal business name

MARCIO GUZMAN

Practice address

1855 Bowles Ave
Suite 210
Fenton, MO 63026-1900

Phone

(630) 991-8315

NPI assigned

Dec 5, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marcio Guzman

Title

Psychotherapist

Phone

(630) 991-8315

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1104257807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7746 DELMAR BLVD",
            "address_2": "APT 1F",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631303917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 BOWLES AVE",
            "address_2": "SUITE 210",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630261900",
            "telephone_number": "630-991-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIO GUZMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-05",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "MARCIO",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "630-991-8315"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MO",
            "license": "2013005503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Fenton, MO
• Providers in Fenton, MO by specialty
• Adult Mental Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.