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1487972576 NPI number — LAURA GENEVA GONZALES MA, LPC, NCC

NPI Number: 1487972576
Health Care Provider/Practitioner: LAURA GENEVA GONZALES MA, LPC, NCC

Information about “1487972576” NPI (LAURA GENEVA GONZALES MA, LPC, NCC) exists in 1487972576 in HTML format HTML  |  1487972576 in plain Text format TXT  |  1487972576 in PDF (Portable Document Format) PDF  |  1487972576 in an XML format XML  formats.

NPI Number : 1487972576 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487972576",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GONZALES",
    "FirstName": "LAURA",
    "MiddleName": "GENEVA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, LPC, NCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "34108 N. 26TH AVENUE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85085-5070",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-717-7213",
    "MailingAddressFaxNumber": "623-566-2062",
    "FirstLinePracticeLocationAddress": "8715 W. UNION HILLS",
    "SecondLinePracticeLocationAddress": "SUITE 105",
    "PracticeLocationAddressCityName": "PEORIA",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85382-7177",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-717-7213",
    "PracticeLocationAddressFaxNumber": "623-566-2062",
    "EnumerationDate": "05/13/2010",
    "LastUpdateDate": "05/13/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "LPC13196",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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