MEDICARE: TIANA CHAZAL WHEELER-BARNES 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
1	1041C0700X	Clinical Social Worker	SWB-2022-0474	NM
2	1041C0700X	Clinical Social Worker	9201-C	NV

General Provider Information

NPI Number	:	1710332119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA CHAZAL WHEELER-BARNES LCSW

Provider Business Mailing Address
First Line	:	8020 S RAINBOW BLVD STE 100-105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6483
Country	:	US
Telephone Number	:	702-577-0431
Fax Number	:	725-204-9500

Provider Business Practice Location Address
First Line	:	8020 S RAINBOW BLVD STE 100-105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6483
Country	:	US
Telephone Number	:	831-402-9083
Fax Number	:	725-204-9500

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

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	01/27/2025

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