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NPI Code Detail

MEDICARE: MS. LO'RECE L MEBANE MSW, LCSW

MEDICARE:  MS. LO'RECE L MEBANE  MSW, 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 Worker3017-CNV

General Provider Information

NPI Number : 1154506459
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LO'RECE L MEBANE MSW, LCSW
Provider Business Mailing Address
First Line : 3030 S JONES BLVD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6793
Country : US
Telephone Number : 702-749-6926
Fax Number : 702-272-2011
Provider Business Practice Location Address
First Line : 3030 S JONES BLVD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6793
Country : US
Telephone Number : 702-749-6926
Fax Number : 702-272-2011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2008
Last Update Date : 10/12/2015

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