Octavia Guilbault, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC3811 Issued in MD

Practice address

122 Langley Rd N Ste a
Glen Burnie, MD 21060

Phone

(410) 222-6785

Fax

(410) 222-6888

NPI assigned

Jul 21, 2011

Last updated

Jan 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Adolescent and Family Services/Addictions

  • Clinic/Center
  • Annapolis, MD
  • NPI 1902175128
  NPD (past)

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1861780033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 LANGLEY RD N STE A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210606531",
            "telephone_number": "301-395-6489",
            "fax_number": "410-366-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 LANGLEY RD N STE A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21060",
            "telephone_number": "410-222-6785",
            "fax_number": "410-222-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10451 Twin Rivers Rd",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210442388",
            "country_code": "US",
            "telephone_number": "410-997-3557",
            "fax_number": "410-964-1791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUILBAULT",
        "first_name": "OCTAVIA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Egal H Gudal, MD
• Renine Miafo Guefah
• Gonzalo Guerra
• Mark Jason Guevarra, DMD
• Guidance of Hope LLC
• Robert Gunn, RPH
• Alok K Gupta, MD
• Gregory Gurfinchel, M.D.
• Mark S. Gurman, DMD
• Katherine Gussman Woods, LCSW C

• Professional Counselor in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.