Healthcare Provider Details

I. General information

NPI: 1437606852
Provider Name (Legal Business Name): LISA MARIE EVERT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA MARIE EVERT LSW

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 E FLAMINGO RD STE 324
LAS VEGAS NV
89121-5067
US

IV. Provider business mailing address

4625 TEAL LN
WINNEMUCCA NV
89445-9062
US

V. Phone/Fax

Practice location:
  • Phone: 702-389-7937
  • Fax:
Mailing address:
  • Phone: 775-304-9323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10878-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: