Provider Demographics
NPI:1750857991
Name:NUNEZ, COLLEEN M (LPC)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:M
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:MARIE
Other - Last Name:NUNEZ-WHITMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:3302 N 7TH ST UNIT 233
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5488
Mailing Address - Country:US
Mailing Address - Phone:480-389-8311
Mailing Address - Fax:
Practice Address - Street 1:483 W. SEED FARM ROAD
Practice Address - Street 2:
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85147-0001
Practice Address - Country:US
Practice Address - Phone:602-528-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional