| Theracounsel Nv, Inc. | |
|
11241 Campanile St Las Vegas NV 89141-6047 | |
| (727) 452-9885 | |
| Not Available |
| Full Name | Theracounsel Nv, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 11241 Campanile St, Las Vegas, Nevada |
| Authorized Official Name and Position | Ihab Issa (DIRECTOR) |
| Authorized Official Contact | 9546478578 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theracounsel Nv, Inc. 2808 Ne 22nd St Ft Lauderdale FL 33305-2804 Ph: (954) 647-8578 | Theracounsel Nv, Inc. 11241 Campanile St Las Vegas NV 89141-6047 Ph: (727) 452-9885 |
| NPI Number | 1255730727 |
|---|---|
| Provider Enumeration Date | 08/20/2014 |
| Last Update Date | 08/20/2014 |
| Medicare PECOS PAC ID | 2961622048 |
|---|---|
| Medicare Enrollment ID | O20141014000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255730727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6758-C (Nevada) | Primary |
| Provider Name | Thomas Mcdonough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750611471 PECOS PAC ID: 9537290663 Enrollment ID: I20141113002235 |
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