Provider Demographics
NPI:1003418856
Name:NORHEIM, EVA CRISTINA HIDALGO (LAC, NCC)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:CRISTINA HIDALGO
Last Name:NORHEIM
Suffix:
Gender:F
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 S FARMER AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5576
Mailing Address - Country:US
Mailing Address - Phone:602-245-6360
Mailing Address - Fax:
Practice Address - Street 1:34975 N NORTH VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-4028
Practice Address - Country:US
Practice Address - Phone:480-525-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty