| Southern Nevada Psychological Services | |
|
2770 S. Maryland Pkwy Ste. 105 Las Vegas NV 89109-1568 | |
| (702) 483-8017 | |
| (702) 202-0923 |
| Full Name | Southern Nevada Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 2770 S. Maryland Pkwy Ste. 105, Las Vegas, Nevada |
| Authorized Official Name and Position | Marshall Morrow (PARTNER) |
| Authorized Official Contact | 7024838017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Nevada Psychological Services 2770 S Maryland Pkwy Ste 105 Las Vegas NV 89109-1564 Ph: (702) 483-0817 | Southern Nevada Psychological Services 2770 S. Maryland Pkwy Ste. 105 Las Vegas NV 89109-1568 Ph: (702) 483-8017 |
| NPI Number | 1467019125 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 08/28/2020 |
| Certification Date | 08/28/2020 |
| Medicare PECOS PAC ID | 9032441258 |
|---|---|
| Medicare Enrollment ID | O20191021002687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467019125 | NPI | - | NPPES |
| 1467019125 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tanisha M Ranger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396094967 PECOS PAC ID: 0941551543 Enrollment ID: I20180920002149 |
| Provider Name | Lauren Chapple Love |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891322749 PECOS PAC ID: 2567870074 Enrollment ID: I20210422001459 |
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