MEDICARE: ANALIZ NOELIA LARACUENTE-ESPINAL

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	101YP2500X	Professional Counselor	A19551	NC

General Provider Information

NPI Number	:	1013788165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANALIZ NOELIA LARACUENTE-ESPINAL

Provider Business Mailing Address
First Line	:	9606 GLENBRIDGE WAY APT 111
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-4313
Country	:	US
Telephone Number	:	704-965-5438
Fax Number	:

Provider Business Practice Location Address
First Line	:	9606 GLENBRIDGE WAY APT 111
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-4313
Country	:	US
Telephone Number	:	704-965-5438
Fax Number	:

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

Provider Enumeration Date	:	01/09/2024
Last Update Date	:	06/19/2025

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