MEDICARE: MIKAELA ESTRADA MSW/LMSW

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	104100000X	Social Worker	11632-M	NV
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1972372449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKAELA ESTRADA MSW/LMSW

Provider Business Mailing Address
First Line	:	2000 S EASTERN AVE STE S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-4100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 S EASTERN AVE STE S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-4100
Country	:	US
Telephone Number	:	702-300-6493
Fax Number	:

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

Provider Enumeration Date	:	12/26/2023
Last Update Date	:	03/16/2026

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