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10161 Park Run Dr Ste 150 Las Vegas NV 89145-8872 | |
| (702) 250-6867 | |
| (702) 793-2901 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 10161 Park Run Dr Ste 150, Las Vegas, Nevada |
| Authorized Official Name and Position | Farbod Valinia (OWNER) |
| Authorized Official Contact | 7022506867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6130 W Flamingo Rd # 635 Las Vegas NV 89103-2280 Ph: (702) 250-6867 | 10161 Park Run Dr Ste 150 Las Vegas NV 89145-8872 Ph: (702) 250-6867 |
| NPI Number | 1194420885 |
|---|---|
| Provider Enumeration Date | 04/03/2023 |
| Last Update Date | 03/01/2024 |
| Certification Date | 03/01/2024 |
| Medicare PECOS PAC ID | 8527405257 |
|---|---|
| Medicare Enrollment ID | O20240318001692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194420885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| Provider Name | Farbod Valinia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235883836 PECOS PAC ID: 9436596160 Enrollment ID: I20240318003334 |
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