MEDICARE: ENDURANCE COUNSELING, PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1497342745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDURANCE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	5645 VERMILLION RIDGE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-6915
Country	:	US
Telephone Number	:	702-499-1457
Fax Number	:	702-995-0036

Provider Business Practice Location Address
First Line	:	7495 W AZURE DR STE 204
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4423
Country	:	US
Telephone Number	:	702-907-3415
Fax Number	:	702-995-0036

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	ASHLEY BROWN
Credential	:	LCPC, LCADC
Telephone Number	:	702-499-1457

Provider Enumeration Date	:	12/21/2020
Last Update Date	:	12/21/2020

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