Provider Demographics
NPI:1245739788
Name:SEMKO, MARIAELENA (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:MARIAELENA
Middle Name:
Last Name:SEMKO
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:MS
Other - First Name:NENA
Other - Middle Name:
Other - Last Name:SEMKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:7121 E EASTLAND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-4938
Mailing Address - Country:US
Mailing Address - Phone:520-623-3960
Mailing Address - Fax:
Practice Address - Street 1:333 N WILMOT RD STE 340
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2607
Practice Address - Country:US
Practice Address - Phone:520-661-3872
Practice Address - Fax:520-618-5833
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10754101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC-10754OtherBEHAVIORAL HEALTH COUNSELING