Healthcare Provider Details

I. General information

NPI: 1952857849
Provider Name (Legal Business Name): LAURA NUNEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 MCCOMBS RD STE C
CHAPARRAL NM
88081-7937
US

IV. Provider business mailing address

1014 N COUNTRY CLUB RD
TUCSON AZ
85716-4239
US

V. Phone/Fax

Practice location:
  • Phone: 575-882-5100
  • Fax: 575-882-1151
Mailing address:
  • Phone: 512-791-5653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number94229
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-20664
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: