MEDICARE: CHRIS ALDEN DOSS 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	101YM0800X	Mental Health Counselor	5430188-3501	UT
2	1041C0700X	Clinical Social Worker	5298-C	NV

General Provider Information

NPI Number	:	1861682494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS ALDEN DOSS LCSW

Provider Business Mailing Address
First Line	:	6600 W CHARLESTON BLVD STE 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1067
Country	:	US
Telephone Number	:	702-763-7443
Fax Number	:	866-284-1860

Provider Business Practice Location Address
First Line	:	6600 W CHARLESTON BLVD STE 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1067
Country	:	US
Telephone Number	:	702-763-7443
Fax Number	:	702-763-7443

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

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	05/21/2022

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