Provider Demographics
NPI:1053694505
Name:PRICKETTE, GUILFORD CLAYBORNE JR (LPC)
Entity type:Individual
Prefix:MR
First Name:GUILFORD
Middle Name:CLAYBORNE
Last Name:PRICKETTE
Suffix:JR
Gender:M
Credentials:LPC
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Mailing Address - Street 1:4320 DIPLOMACY DR
Mailing Address - Street 2:SUITE 2121
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5925
Mailing Address - Country:US
Mailing Address - Phone:907-729-3373
Mailing Address - Fax:907-729-8997
Practice Address - Street 1:4320 DIPLOMACY DR
Practice Address - Street 2:SUITE 2121
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5925
Practice Address - Country:US
Practice Address - Phone:907-729-3373
Practice Address - Fax:907-729-8997
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional