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NPI Code Detail

MEDICARE: ELIZABETH DEYOUNG LCSW

MEDICARE:   ELIZABETH  DEYOUNG  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 Worker6568-CNV

General Provider Information

NPI Number : 1942639273
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH DEYOUNG LCSW
Provider Business Mailing Address
First Line : PO BOX 232141
Second Line :
City : LAS VEGAS
State : NV
Zip : 89105-2141
Country : US
Telephone Number : 702-239-7182
Fax Number :
Provider Business Practice Location Address
First Line : 8565 S EASTERN AVE STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2906
Country : US
Telephone Number : 702-239-7182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2013
Last Update Date : 02/26/2019

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Directions to “ ELIZABETH DEYOUNG LCSW” Practice Location

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