Healthcare Provider Details

I. General information

NPI: 1699254565
Provider Name (Legal Business Name): SUMMER ANN PFARR CADC, BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N BOULDER HWY
HENDERSON NV
89011-4120
US

IV. Provider business mailing address

3321 N BUFFALO DRIVE SUITE 200
LAS VEGA NV
89129
US

V. Phone/Fax

Practice location:
  • Phone: 702-558-8600
  • Fax: 702-558-8700
Mailing address:
  • Phone: 702-515-1374
  • Fax: 702-331-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00751-C
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number08260-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: