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General NPI Number Information
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NPI Number | 1295598746
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Entity Type | Individual
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Provider Name | MILISSEN NUNEZ MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1800 JOHN F KENNEDY BLVD STE 1404
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City | PHILADELPHIA
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State | PA
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Zip | 19103-7417
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Country | US
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Telephone | 855-675-4010
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | 1027 GREGORY LN
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City | TEMPLE
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State | PA
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Zip | 19560-9583
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Country | US
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Telephone | 917-783-0408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC018268
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License Number State | PA
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