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General NPI Number Information
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NPI Number | 1639087869
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Entity Type | Individual
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Provider Name | VICTOR EMANUEL LENNARTZ LAC
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Gender | Male
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Dates
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Enumeration Date | 08/29/2026
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Last Update Date | 08/29/2026
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Provider Practice Location Address
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Address Line | 6303 E TANQUE VERDE RD STE 210
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City | TUCSON
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State | AZ
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Zip | 85715-3859
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Country | US
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Telephone | 520-423-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 4277 N RIVER GROVE CIR APT 120
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City | TUCSON
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State | AZ
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Zip | 85719-1160
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Country | US
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Telephone | 520-505-2198
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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 | LAC-23520
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License Number State | AZ
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