MEDICARE: SONI TIOUNOFF MA LPC

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	101YM0800X	Mental Health Counselor	LPC 11853	AZ

General Provider Information

NPI Number	:	1932657947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONI TIOUNOFF MA LPC

Provider Business Mailing Address
First Line	:	1200 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3625
Country	:	US
Telephone Number	:	520-639-7036
Fax Number	:	520-326-0861

Provider Business Practice Location Address
First Line	:	535 N WILMOT RD STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2629
Country	:	US
Telephone Number	:	520-694-1234
Fax Number	:	520-694-2185

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

Provider Enumeration Date	:	09/19/2016
Last Update Date	:	07/15/2025

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