Healthcare Provider Details

I. General information

NPI: 1033905245
Provider Name (Legal Business Name): CARE AND CRISIS CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 CORONADO CENTER DR STE 200
HENDERSON NV
89052-3977
US

IV. Provider business mailing address

871 CORONADO CENTER DR STE 200
HENDERSON NV
89052-3977
US

V. Phone/Fax

Practice location:
  • Phone: 702-723-2273
  • Fax:
Mailing address:
  • Phone: 702-723-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DENICIA POWELL
Title or Position: DIRECTOR
Credential:
Phone: 702-723-2273