Provider Demographics
NPI:1962692285
Name:ZUBIRIA, CARLA C (LPC, MA)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:C
Last Name:ZUBIRIA
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 E PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-5939
Mailing Address - Country:US
Mailing Address - Phone:480-628-5648
Mailing Address - Fax:
Practice Address - Street 1:3112 CLEARWATER DR
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7187
Practice Address - Country:US
Practice Address - Phone:928-541-9885
Practice Address - Fax:928-541-9952
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional