MEDICARE: ZONA PETRELLI LCSW, CSW-G

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	1041C0700X	Clinical Social Worker	7472-C	NV

General Provider Information

NPI Number	:	1114262011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZONA PETRELLI LCSW, CSW-G

Provider Business Mailing Address
First Line	:	7818 LANGARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-4860
Country	:	US
Telephone Number	:	702-460-1897
Fax Number	:

Provider Business Practice Location Address
First Line	:	7818 LANGARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-4860
Country	:	US
Telephone Number	:	702-460-1897
Fax Number	:

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

Provider Enumeration Date	:	12/03/2012
Last Update Date	:	06/20/2025

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