| Candlelight Mental Health Counseling Center Llc | |
|
5258 S Eastern Ave Ste 105 Las Vegas NV 89119-2327 | |
| (702) 464-5080 | |
| Not Available |
| Full Name | Candlelight Mental Health Counseling Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5258 S Eastern Ave Ste 105, Las Vegas, Nevada |
| Authorized Official Name and Position | Shiba Neomi Amezcua (CEO) |
| Authorized Official Contact | 7027389064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Candlelight Mental Health Counseling Center Llc 700 Rocky Trail Rd Henderson NV 89014-0321 Ph: (702) 738-9064 | Candlelight Mental Health Counseling Center Llc 5258 S Eastern Ave Ste 105 Las Vegas NV 89119-2327 Ph: (702) 464-5080 |
| NPI Number | 1164089488 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 05/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164089488 | NPI | - | NPPES |
| NV20191376022 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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