Provider Demographics
NPI:1437997608
Name:GUERRERO, LINA REBECCA (MPA, LMSW, LCDC-I)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:REBECCA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MPA, LMSW, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 JOHN CAMPBELLS TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6918
Mailing Address - Country:US
Mailing Address - Phone:512-968-0228
Mailing Address - Fax:
Practice Address - Street 1:5800 BERKMAN DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2625
Practice Address - Country:US
Practice Address - Phone:512-829-8738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1127861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical