MEDICARE: SOUTHER NEVADA ADULT MENTAL HEALTH

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	273R00000X	Psychiatric Hospital Unit	9126	NV

General Provider Information

NPI Number	:	1568579076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHER NEVADA ADULT MENTAL HEALTH

Provider Business Mailing Address
First Line	:	6161 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1126
Country	:	US
Telephone Number	:	702-486-6000
Fax Number	:	702-486-6248

Provider Business Practice Location Address
First Line	:	6161 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1126
Country	:	US
Telephone Number	:	702-486-6000
Fax Number	:	702-486-6248

Authorized Official
Title or Position	:	PSYCHIATRIST
Name	:	DR. MARIAM MARVASTI
Credential	:	MD
Telephone Number	:	702-278-6444

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	08/27/2007

Similar Medicare Providers

1720218597 — STATE OF NEVADA - SNCAS PSYCH
Practice Location Address:

6171 W CHARLESTON BLVD BLDG 11
LAS VEGAS, NV
89146-1126

Practice Phone: 702-486-6100
Practice Fax: 702-486-6057

1891756920 — SOUTHERN NEVADA ADULT MENTAL HEALTH
Practice Location Address:

6161 W CHARLESTON BLVD
LAS VEGAS, NV
89146-1126

Practice Phone: 702-486-6000
Practice Fax: 702-486-8077

1811953003 — STATE OF NEVADA - DWTC
Practice Location Address:

6171 W CHARLESTON BLVD BLDG 17
LAS VEGAS, NV
89146-1126

Practice Phone: 702-486-6100
Practice Fax: 702-486-6057

1609883552 — JOHN PATRICK HARPER LCSW
Practice Location Address:

6171 W CHARLESTON BLVD , BUILDING 8
LAS VEGAS, NV
89146-1126

Practice Phone: 702-486-6871
Practice Fax: 702-486-6871

1164523296 — ADELWISA VIADO LIZADA MD
Practice Location Address:

6161 W CHARLESTON BLVD
LAS VEGAS, NV
89146-1126

Practice Phone: 702-486-6045
Practice Fax: 702-486-0411

1609945047 — MRS. NANCY LEAH CALDWELL LCSW
Practice Location Address:

6171 W CHARLESTON BLVD # 15
LAS VEGAS, NV
89146-1126

Practice Phone: 702-486-0003
Practice Fax: 702-455-8902

Directions to “SOUTHER NEVADA ADULT MENTAL HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.