MEDICARE: ESTEL 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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1538869524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESTEL COUNSELING PLLC

Provider Business Mailing Address
First Line	:	239 DOUGRAM AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-5647
Country	:	US
Telephone Number	:	702-552-8099
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 DOUGRAM AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-5647
Country	:	US
Telephone Number	:	702-552-8099
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COLIN PRYOR
Credential	:	LCSW, LCADC
Telephone Number	:	631-944-0969

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	03/08/2023

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