Provider Demographics
NPI:1285061317
Name:PONCE, JOSEPH MICHAEL (LPC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:PONCE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 W SPEEDWAY BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7686
Mailing Address - Country:US
Mailing Address - Phone:520-623-0344
Mailing Address - Fax:520-770-8578
Practice Address - Street 1:140 W SPEEDWAY BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7686
Practice Address - Country:US
Practice Address - Phone:520-623-0344
Practice Address - Fax:520-770-8578
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional