MEDICARE: ARIANNA KATYA WEIDE LMSW, CSW-I

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	104100000X	Social Worker	8483-M	NV

General Provider Information

NPI Number	:	1083340806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANNA KATYA WEIDE LMSW, CSW-I

Provider Business Mailing Address
First Line	:	7939 STORMY FALLS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3729
Country	:	US
Telephone Number	:	702-882-1133
Fax Number	:

Provider Business Practice Location Address
First Line	:	7939 STORMY FALLS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3729
Country	:	US
Telephone Number	:	702-882-1133
Fax Number	:

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

Provider Enumeration Date	:	07/25/2022
Last Update Date	:	07/25/2022

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