| Therapy Of Southern Nevada Llc | |
|
3340 Topaz St Ste 170 Las Vegas NV 89121-3906 | |
| (702) 268-7604 | |
| (702) 442-8840 |
| Full Name | Therapy Of Southern Nevada Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3340 Topaz St Ste 170, Las Vegas, Nevada |
| Authorized Official Name and Position | Joe Whitley (OWNER) |
| Authorized Official Contact | 7022687604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Of Southern Nevada Llc 3340 Topaz St Ste 170 Las Vegas NV 89121-3906 Ph: (702) 268-7604 | Therapy Of Southern Nevada Llc 3340 Topaz St Ste 170 Las Vegas NV 89121-3906 Ph: (702) 268-7604 |
| NPI Number | 1821698556 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 04/21/2022 |
| Certification Date | 04/21/2022 |
| Medicare PECOS PAC ID | 6507278959 |
|---|---|
| Medicare Enrollment ID | O20201209001644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821698556 | NPI | - | NPPES |
| 250011146 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Saritha L Farris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194029785 PECOS PAC ID: 0244517928 Enrollment ID: I20170505001523 |
| Provider Name | Dithra Ann Cotton-lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487159182 PECOS PAC ID: 0749539161 Enrollment ID: I20180817002985 |
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