Healthcare Provider Details
I. General information
NPI: 1225379266
Provider Name (Legal Business Name): KARTIKA DICKENS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/14/2013
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11500 S EASTERN AVE STE 150
HENDERSON NV
89052-5576
US
IV. Provider business mailing address
11500 S EASTERN AVE STE 150
HENDERSON NV
89052-5576
US
V. Phone/Fax
- Phone: 702-751-5055
- Fax: 702-552-7138
- Phone: 702-751-5055
- Fax: 702-552-7138
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MI0618 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: