| Shelly Ervin Lcsw Llc | |
|
500 N Rainbow Blvd Ste 300 Las Vegas NV 89107-1061 | |
| (702) 859-6925 | |
| Not Available |
| Full Name | Shelly Ervin Lcsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 N Rainbow Blvd Ste 300, Las Vegas, Nevada |
| Authorized Official Name and Position | Karen Michelle Ervin (OWNER) |
| Authorized Official Contact | 7028596925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelly Ervin Lcsw Llc 3600 Connell St Las Vegas NV 89129-7900 Ph: (702) 859-6925 | Shelly Ervin Lcsw Llc 500 N Rainbow Blvd Ste 300 Las Vegas NV 89107-1061 Ph: (702) 859-6925 |
| NPI Number | 1689430100 |
|---|---|
| Provider Enumeration Date | 02/22/2024 |
| Last Update Date | 02/22/2024 |
| Certification Date | 02/22/2024 |
| Medicare PECOS PAC ID | 8123467982 |
|---|---|
| Medicare Enrollment ID | O20240412004219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689430100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Karen M Ervin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619462538 PECOS PAC ID: 8224417084 Enrollment ID: I20220624001076 |
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