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NPI Code Detail

MEDICARE: MICHELLE V SANDOVAL LCSW

MEDICARE: MICHELLE V SANDOVAL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6292-CNV

General Provider Information

NPI Number : 1003169905
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE V SANDOVAL LCSW
Provider Business Mailing Address
First Line : 1825 PINION RD
Second Line : SUITE A
City : ELKO
State : NV
Zip : 89801-8319
Country : US
Telephone Number : 775-434-9011
Fax Number : 775-738-8842
Provider Business Practice Location Address
First Line : 1825 PINION RD
Second Line : SUITE A
City : ELKO
State : NV
Zip : 89801-8319
Country : US
Telephone Number : 775-434-9011
Fax Number : 775-738-8842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2012
Last Update Date : 09/16/2021

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Directions to “ MICHELLE V SANDOVAL LCSW” Practice Location

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