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NPI Code Detail

MEDICARE: MS. NICOLE MARIE BURCHETT MFT-STUDENT

MEDICARE:  MS. NICOLE MARIE BURCHETT  MFT-STUDENT
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
1106H00000XMarriage & Family TherapistNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083181481
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE MARIE BURCHETT MFT-STUDENT
Provider Business Mailing Address
First Line : 1848 DEL MONICO WAY
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031
Country : US
Telephone Number : 702-355-6555
Fax Number :
Provider Business Practice Location Address
First Line : 7473 W. LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128
Country : US
Telephone Number : 702-670-0043
Fax Number : 702-973-7373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 12/10/2025

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Directions to “ MS. NICOLE MARIE BURCHETT MFT-STUDENT” Practice Location

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