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NPI Code Detail

MEDICARE: MARIA ELLIS LCSW

MEDICARE:   MARIA  ELLIS  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 WorkerNV

General Provider Information

NPI Number : 1760700900
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA ELLIS LCSW
Provider Business Mailing Address
First Line : 6775 CAVATINA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-6776
Country : US
Telephone Number : 702-715-2212
Fax Number : 702-750-2308
Provider Business Practice Location Address
First Line : 6879 W CHARLESTON BLVD STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1672
Country : US
Telephone Number : 702-715-2212
Fax Number : 702-750-2308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2010
Last Update Date : 01/12/2017

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Directions to “ MARIA ELLIS LCSW” Practice Location

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