Healthcare Provider Details

I. General information

NPI: 1871380659
Provider Name (Legal Business Name): NADIYAH PRATT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2598 WINDMILL PKWY STE 100
HENDERSON NV
89074-5476
US

IV. Provider business mailing address

2598 WINDMILL PKWY STE 100
HENDERSON NV
89074-5476
US

V. Phone/Fax

Practice location:
  • Phone: 702-248-0000
  • Fax: 702-933-5545
Mailing address:
  • Phone: 702-248-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number07993-I
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: