Provider Demographics
NPI:1285518696
Name:URENO, ESMERALDA G (MA LPC)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:G
Last Name:URENO
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 MILKY WAY
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-1002
Mailing Address - Country:US
Mailing Address - Phone:714-854-2612
Mailing Address - Fax:
Practice Address - Street 1:1515 E CEDAR AVE STE B-4
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1645
Practice Address - Country:US
Practice Address - Phone:928-779-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-23983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health