Individual provider Active NPI

Laura Nunez, MS, LMFT

  • Marriage & Family Therapist
  • Colona, IL
National Provider Identifier
1497143945
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.000991 Issued in IL
Practice address
223 1 Street
Colona, IL 61241
Phone
(309) 431-1555
Fax
(855) 515-0810
NPI assigned
Jan 7, 2015
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.000991 IL Primary

Addresses

Primary practice location

223 1 Street
Colona, IL 61241

Mailing address

4709 44TH St Ste 5
Rock Island, IL 61201-7187
Phone (309) 793-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
166.000991ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Lifestyles Counseling Solutions, LLC Marriage & Family Therapist CurrentSince Nov 1, 2020 Accepting new patients
Youth Service Bureau of Rock Island Co. Past Accepting new patients

Locations

223 1st Ave
Colona, IL 61241
Phone (309) 431-1555

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1497143945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 44TH ST STE 5",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017187",
            "telephone_number": "309-793-3460",
            "fax_number": "309-732-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 1 STREET",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "61241",
            "telephone_number": "309-431-1555",
            "fax_number": "855-515-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "LAURA",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colona, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.