MEDICARE: MS. SOUNEH AREVALO LMFT

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
1	101YM0800X	Mental Health Counselor	01423	NV
2	106H00000X	Marriage & Family Therapist	53639	CA
3	106H00000X	Marriage & Family Therapist	01423	NV

General Provider Information

NPI Number	:	1033305412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SOUNEH AREVALO LMFT

Provider Business Mailing Address
First Line	:	4857 NARDINI AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3823
Country	:	US
Telephone Number	:	702-970-3535
Fax Number	:	702-441-0915

Provider Business Practice Location Address
First Line	:	1070 W HORIZON RIDGE PKWY STE 210
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-6020
Country	:	US
Telephone Number	:	702-970-3535
Fax Number	:	702-441-0915

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	10/29/2024

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