| Trillity Care Counseling Llc | |
|
4760 S. Pecos Rd 203-1 Las Vegas NV 89121 | |
| (702) 601-2697 | |
| Not Available |
| Full Name | Trillity Care Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4760 S. Pecos Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Beverly Natausha Williams (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7026012697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trillity Care Counseling Llc 4760 S. Pecos Rd 203-1 Las Vegas NV 89121 Ph: (702) 601-2697 | Trillity Care Counseling Llc 4760 S. Pecos Rd 203-1 Las Vegas NV 89121 Ph: (702) 601-2697 |
| NPI Number | 1487101549 |
|---|---|
| Provider Enumeration Date | 09/07/2016 |
| Last Update Date | 09/07/2016 |
| Medicare PECOS PAC ID | 3971873639 |
|---|---|
| Medicare Enrollment ID | O20170728000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487101549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 21061517540 (Nevada) | Primary |
| Provider Name | Ladwana J Retic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851682587 PECOS PAC ID: 6002048279 Enrollment ID: I20140423000144 |
| Provider Name | Gary E Brundage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861707036 PECOS PAC ID: 2264701481 Enrollment ID: I20170703000873 |
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