Healthcare Provider Details

I. General information

NPI: 1770417552
Provider Name (Legal Business Name): ACCESS NEVADA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N PECOS RD STE E
HENDERSON NV
89074-1352
US

IV. Provider business mailing address

305 N PECOS RD STE E
HENDERSON NV
89074-1352
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-1665
  • Fax: 702-463-1665
Mailing address:
  • Phone: 702-463-1665
  • Fax: 702-463-1665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SERENA FORD
Title or Position: BILLER
Credential:
Phone: 702-463-1665