Provider Demographics
NPI:1336380732
Name:LAURENNE, SUNNY AVENS (LMHC)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:AVENS
Last Name:LAURENNE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AVENS
Other - Middle Name:SUNNY
Other - Last Name:LAURENNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:600 1ST ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2311
Mailing Address - Country:US
Mailing Address - Phone:505-224-9124
Mailing Address - Fax:505-247-9503
Practice Address - Street 1:600 1ST ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2311
Practice Address - Country:US
Practice Address - Phone:505-224-9124
Practice Address - Fax:505-247-9503
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0108811101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health