Mary E Guillermo, LCAT, R-DMT

Primary specialty

Art TherapistTaxonomy code 221700000X

License

002853-01 Issued in NY

Practice address

1623 Kings Hwy
Brooklyn, NY 11229-1209

Phone

(929) 273-7601

NPI assigned

Sep 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Children of Promise, Nyc

  • Adolescent and Children Mental Health Clinic/Center
  • Brooklyn, NY
  • NPI 1164723714
  NPD (past)

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1972273589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209",
            "telephone_number": "929-273-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209",
            "telephone_number": "929-273-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLERMO",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "LCAT, R-DMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "NY",
            "license": "R-DMT-2476",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002853-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Guillaume
• Christina D. Guillen, M.D.
• Enrique Ficy Guillen
• Eulenis Guillen, MA PSYCHOLOGY
• Guillermo Gilberto Gallardo MD PLLC
• Andre D. Guillet, D.P.M.
• Maiya Guillory, CNM
• Jose Marie Guilloteau
• Paula Guimaraes de Sa
• Anna Guindi

• Art Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Art Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.