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2625 Wigwam Pkwy Ste 108 Henderson NV 89074-7326 | |
| (747) 205-0896 | |
| (702) 472-8909 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 2625 Wigwam Pkwy Ste 108, Henderson, Nevada |
| Authorized Official Name and Position | Adella Jaeger (DIRECTOR) |
| Authorized Official Contact | 7472050896 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2625 Wigwam Pkwy Ste 108 Henderson NV 89074-7326 Ph: (747) 205-0896 | 2625 Wigwam Pkwy Ste 108 Henderson NV 89074-7326 Ph: (747) 205-0896 |
| NPI Number | 1689272130 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 5698183937 |
|---|---|
| Medicare Enrollment ID | O20210426001929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689272130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Adella Jaeger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194290692 PECOS PAC ID: 8224449665 Enrollment ID: I20210426002408 |
| Provider Name | Leah Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720605793 PECOS PAC ID: 9032519392 Enrollment ID: I20210609000254 |
| Provider Name | Mia Weiler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912548546 PECOS PAC ID: 1557806734 Enrollment ID: I20240711003179 |
| Provider Name | Jessica M Taylor |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467927756 PECOS PAC ID: 7315483898 Enrollment ID: I20240719002815 |
| Provider Name | Sharon Sally Arfa |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477192789 PECOS PAC ID: 8527504927 Enrollment ID: I20240722002812 |
| Provider Name | Brittany Holtzclaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568612711 PECOS PAC ID: 6103364807 Enrollment ID: I20240813001621 |
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