Provider Demographics
NPI:1083733752
Name:VUCUREVICH, MARY (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:VUCUREVICH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5303
Mailing Address - Country:US
Mailing Address - Phone:602-258-1770
Mailing Address - Fax:602-870-3890
Practice Address - Street 1:7111 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5303
Practice Address - Country:US
Practice Address - Phone:602-258-1770
Practice Address - Fax:602-870-3890
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0910101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional