Healthcare Provider Details

I. General information

NPI: 1316154354
Provider Name (Legal Business Name): ANNE HEPPENSTALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8975 S PECOS RD
HENDERSON NV
89074-7160
US

IV. Provider business mailing address

8975 S PECOS RD STE 8D
HENDERSON NV
89074-7161
US

V. Phone/Fax

Practice location:
  • Phone: 702-563-1000
  • Fax: 702-563-1001
Mailing address:
  • Phone: 702-563-1000
  • Fax: 702-563-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4753-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: