MEDICARE: ICARE WELLNESS & COUNSELING LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1215810742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE WELLNESS & COUNSELING LLC

Provider Business Mailing Address
First Line	:	10629 CLEAR MEADOWS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-7363
Country	:	US
Telephone Number	:	714-350-1806
Fax Number	:

Provider Business Practice Location Address
First Line	:	10629 CLEAR MEADOWS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-7363
Country	:	US
Telephone Number	:	714-350-1806
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENCY MARTY MANGLICMOT
Credential	:
Telephone Number	:	714-350-1806

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	07/30/2025

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Directions to “ICARE WELLNESS & COUNSELING LLC ” Practice Location

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