| New Horizons Psychiatric Services Mathisen Pllc | |
|
7361 W Charleston Blvd Ste 130 Las Vegas NV 89117-1576 | |
| (702) 545-0229 | |
| Not Available |
| Full Name | New Horizons Psychiatric Services Mathisen Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7361 W Charleston Blvd Ste 130, Las Vegas, Nevada |
| Authorized Official Name and Position | Michael Mathisen (OWNER) |
| Authorized Official Contact | 7025450229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Horizons Psychiatric Services Mathisen Pllc 7361 W Charleston Blvd Ste 130 Las Vegas NV 89117-1576 Ph: (702) 545-0229 | New Horizons Psychiatric Services Mathisen Pllc 7361 W Charleston Blvd Ste 130 Las Vegas NV 89117-1576 Ph: (702) 545-0229 |
| NPI Number | 1346977022 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 09/01/2022 |
| Certification Date | 09/01/2022 |
| Medicare PECOS PAC ID | 3577949593 |
|---|---|
| Medicare Enrollment ID | O20220928003013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346977022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Michael Todd Mathisen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114487881 PECOS PAC ID: 0648504605 Enrollment ID: I20190625001488 |
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