Kelly Sue Guidry, LPC-S, LSOTP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

67229 Issued in TX

Practice address

25511 Budde Rd Ste 1303
Spring, TX 77380-2092

Phone

(281) 210-6677

NPI assigned

Nov 28, 2012

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

Other names 1

• Ms. Kelly Sue Greggerson Former name

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.

• Lauren Pasqua, PSYD

  • Clinical Child & Adolescent Psychologist
  • Spring, TX
  • NPI 1649756222
  NPD (past)

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1972848109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25511 BUDDE RD STE 1303",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802092",
            "telephone_number": "281-210-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25511 BUDDE RD STE 1303",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802092",
            "telephone_number": "281-210-6677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2119 Havenhouse Dr",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773862516",
            "country_code": "US",
            "telephone_number": "832-380-8773",
            "fax_number": "832-380-8773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LPC-S, LSOTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GREGGERSON",
            "middle_name": "SUE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Spring, TX
• Providers in Spring, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.