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7495 W Azure Dr Ste 247 Las Vegas NV 89130-4416 | |
| (702) 742-1500 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 7495 W Azure Dr Ste 247, Las Vegas, Nevada |
| Authorized Official Name and Position | Stephanie Elswick Partida (OWNER) |
| Authorized Official Contact | 7609370118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7495 W Azure Dr Ste 247 Las Vegas NV 89130-4416 Ph: (760) 937-0118 | 7495 W Azure Dr Ste 247 Las Vegas NV 89130-4416 Ph: (702) 742-1500 |
| NPI Number | 1073269122 |
|---|---|
| Provider Enumeration Date | 02/28/2022 |
| Last Update Date | 03/30/2023 |
| Certification Date | 03/30/2023 |
| Medicare PECOS PAC ID | 8123480902 |
|---|---|
| Medicare Enrollment ID | O20230810001363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073269122 | NPI | - | NPPES |
| NV20212309567 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Stephanie Partida |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184182875 PECOS PAC ID: 9032571815 Enrollment ID: I20230810001434 |
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