MEDICARE: EMIRE OLMEZTOPRAK MS, MFT, LCADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	00414	NV
2	106H00000X	Marriage & Family Therapist	01237	NV

General Provider Information

NPI Number	:	1780987222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMIRE OLMEZTOPRAK MS, MFT, LCADC

Provider Business Mailing Address
First Line	:	4045 SPENCER ST STE A48
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5245
Country	:	US
Telephone Number	:	702-483-8260
Fax Number	:	702-209-3599

Provider Business Practice Location Address
First Line	:	4045 SPENCER ST STE A48
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5245
Country	:	US
Telephone Number	:	702-483-8260
Fax Number	:	702-209-3599

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

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	02/23/2022

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