Provider Demographics
NPI:1598894933
Name:ZAMORA, OPHELIA L (LPC)
Entity type:Individual
Prefix:
First Name:OPHELIA
Middle Name:L
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-670-3909
Mailing Address - Fax:520-309-2560
Practice Address - Street 1:3950 S COUNTRY CLUB RD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2203
Practice Address - Country:US
Practice Address - Phone:520-670-3909
Practice Address - Fax:520-309-2560
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ760843051OtherTAX ID NUMBER