Provider Demographics
NPI:1437616760
Name:PLOUFFE, NANCY JEANETTA (LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEANETTA
Last Name:PLOUFFE
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 1:320 E DEUCE OF CLUBS
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-4808
Mailing Address - Country:US
Mailing Address - Phone:928-532-3926
Mailing Address - Fax:
Practice Address - Street 1:320 E DEUCE OF CLUBS
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-4808
Practice Address - Country:US
Practice Address - Phone:928-532-3926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008297101YP2500X
AZLPC-17881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional