Individual provider Active NPI

Anne Therese Louise De Guzman, LMFT

  • Marriage & Family Therapist
  • West Haven, CT
National Provider Identifier
1578990909
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1734 Issued in CT
Practice address
285 Main St
West Haven, CT 06516-7307
Phone
(203) 503-3409
Fax
(203) 503-3414
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1734 CT Primary

Addresses

Primary practice location

285 Main St
West Haven, CT 06516-7307

Mailing address

400 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3174

Other identifiers 1

IdentifierTypeStateIssuer
004235918MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Resilience Counseling, LLC Marriage & Family Therapist Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1578990909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065167307",
            "telephone_number": "203-503-3409",
            "fax_number": "203-503-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "ANNE THERESE",
        "middle_name": "LOUISE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.