Provider Demographics
NPI:1316641061
Name:BENCOMO, DENISE YVONNE (LPC, LASAC)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:YVONNE
Last Name:BENCOMO
Suffix:
Gender:F
Credentials:LPC, LASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 S CAMINO DE OESTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-9308
Mailing Address - Country:US
Mailing Address - Phone:520-879-6003
Mailing Address - Fax:
Practice Address - Street 1:7490 S CAMINO DE OESTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-9308
Practice Address - Country:US
Practice Address - Phone:520-879-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLASAC-15311101YA0400X
AZLPC-20924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)