Healthcare Provider Details

I. General information

NPI: 1790376028
Provider Name (Legal Business Name): LILI K EQUIHUA M.S., MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 W WARM SPRINGS RD STE 109
HENDERSON NV
89014-7632
US

IV. Provider business mailing address

500 E WARM SPRINGS RD STE 100
LAS VEGAS NV
89119-4345
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-0519
  • Fax:
Mailing address:
  • Phone: 702-279-0658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMI3188
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: