Provider Demographics
NPI:1205659307
Name:NDUKWU, DENISE (LMHCA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:NDUKWU
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3511
Mailing Address - Country:US
Mailing Address - Phone:219-229-0109
Mailing Address - Fax:
Practice Address - Street 1:910 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3505
Practice Address - Country:US
Practice Address - Phone:219-229-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health