Provider Demographics
NPI:1427179415
Name:VUKAS, CONSTANCE A (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:A
Last Name:VUKAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19005 N CONCHO CIR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373-1404
Mailing Address - Country:US
Mailing Address - Phone:701-866-9209
Mailing Address - Fax:
Practice Address - Street 1:17235 N 75TH AVE STE F135
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0825
Practice Address - Country:US
Practice Address - Phone:480-801-2985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1413106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN233463000OtherMHCP PROVIDER NUMBER