MEDICARE: STEFANIE NICOLE MARISSA CULLUM

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	1041C0700X	Clinical Social Worker
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1699361527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE NICOLE MARISSA CULLUM

Provider Business Mailing Address
First Line	:	7053 PLACID LAKE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1524
Country	:	US
Telephone Number	:	702-755-2578
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 SAINT ROSE PKWY STE 306
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7790
Country	:	US
Telephone Number	:	702-755-2578
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2020
Last Update Date	:	12/15/2020

Similar Medicare Providers

1609155902 — MIGNON HOOVER
Practice Location Address:

2520 SAINT ROSE PKWY STE 306
HENDERSON, NV
89074-7790

Practice Phone: 702-808-8141
Practice Fax:

1881010437 — MISS JENAE LINDSEY
Practice Location Address:

2520 SAINT ROSE PKWY STE 306
HENDERSON, NV
89074-7790

Practice Phone: 801-885-5836
Practice Fax:

1003210923 — MRS. OLIVIA JOY STOKER LCSW
Practice Location Address:

2520 SAINT ROSE PKWY STE 310
HENDERSON, NV
89074-7790

Practice Phone: 702-496-6562
Practice Fax:

1760067862 — RACHEL HARTSHORN
Practice Location Address:

2520 SAINT ROSE PKWY STE 306
HENDERSON, NV
89074-7790

Practice Phone: 702-487-7249
Practice Fax:

1649902859 — HELLO CALM
Practice Location Address:

2520 SAINT ROSE PKWY STE 316
HENDERSON, NV
89074-7790

Practice Phone: 702-381-2192
Practice Fax:

1497458004 — DESERT BLOOM RECOVERY LTD.
Practice Location Address:

2520 SAINT ROSE PKWY STE 306
HENDERSON, NV
89074-7790

Practice Phone: 801-885-5836
Practice Fax:

Directions to “ STEFANIE NICOLE MARISSA CULLUM ” 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.