MEDICARE: MR. ROY D. CHUKWUEMEKA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC-16983	AZ

General Provider Information

NPI Number	:	1063949170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROY D. CHUKWUEMEKA LPC

Provider Business Mailing Address
First Line	:	1748 LEISURE WORLD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-2335
Country	:	US
Telephone Number	:	623-396-4610
Fax Number	:

Provider Business Practice Location Address
First Line	:	1748 LEISURE WORLD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-2335
Country	:	US
Telephone Number	:	623-396-4610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2017
Last Update Date	:	03/11/2026

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