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NPI Code Detail

MEDICARE: ERICKA L SEVERS LCSW

MEDICARE: ERICKA L SEVERS 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 Worker5901-CNV

General Provider Information

NPI Number : 1629309208
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICKA L SEVERS LCSW
Provider Business Mailing Address
First Line : 3435 W CRAIG RD STE A
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-5116
Country : US
Telephone Number : 702-675-6314
Fax Number : 702-476-9697
Provider Business Practice Location Address
First Line : 3435 W CRAIG RD STE A
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-5116
Country : US
Telephone Number : 702-675-6314
Fax Number : 702-476-9697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2010
Last Update Date : 07/21/2022

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