Healthcare Provider Details

I. General information

NPI: 1174882484
Provider Name (Legal Business Name): CHRISTIAN LAZARTE LMFT, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 PECOS MCLEOD STE 100
LAS VEGAS NV
89121-3811
US

IV. Provider business mailing address

10620 SOUTHERN HIGHLANDS PKWY STE 110
LAS VEGAS NV
89141-4372
US

V. Phone/Fax

Practice location:
  • Phone: 702-389-7937
  • Fax:
Mailing address:
  • Phone: 702-389-7937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4541
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: