Provider Demographics
NPI:1790490597
Name:ZUNIGA, LUIS ENRIQUE JR (MS, LCMHCA)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ENRIQUE
Last Name:ZUNIGA
Suffix:JR
Gender:M
Credentials:MS, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WYNDHAM CIR APT A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-1657
Mailing Address - Country:US
Mailing Address - Phone:910-316-3212
Mailing Address - Fax:
Practice Address - Street 1:2563 DOC LOFTIN RD
Practice Address - Street 2:
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-8559
Practice Address - Country:US
Practice Address - Phone:252-495-8520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health