Provider Demographics
NPI:1952857849
Name:NUNEZ, LAURA (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:NUNEZ
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 1:1014 N COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4239
Mailing Address - Country:US
Mailing Address - Phone:512-791-5653
Mailing Address - Fax:
Practice Address - Street 1:320 MCCOMBS RD STE C
Practice Address - Street 2:
Practice Address - City:CHAPARRAL
Practice Address - State:NM
Practice Address - Zip Code:88081-7937
Practice Address - Country:US
Practice Address - Phone:575-882-5100
Practice Address - Fax:575-882-1151
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94229101YP2500X
AZLPC-20664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM64153274Medicaid