Healthcare Provider Details

I. General information

NPI: 1023490851
Provider Name (Legal Business Name): OPEN ARMS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W ATLANTIC AVE
HENDERSON NV
89015-7102
US

IV. Provider business mailing address

203 S WATER ST # 200
HENDERSON NV
89015-7226
US

V. Phone/Fax

Practice location:
  • Phone: 702-823-4300
  • Fax: 702-906-1844
Mailing address:
  • Phone: 702-823-4300
  • Fax: 702-906-1844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: STACY HOLBROOK
Title or Position: OWNER
Credential:
Phone: 702-823-4300