Healthcare Provider Details

I. General information

NPI: 1457650533
Provider Name (Legal Business Name): MR. CHARLES ANDREW ESCARTIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5763 W OAKEY BLVD
LAS VEGAS NV
89146-1248
US

IV. Provider business mailing address

5763 W OAKEY BLVD
LAS VEGAS NV
89146-1248
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-5001
  • Fax: 702-968-5004
Mailing address:
  • Phone: 702-968-5001
  • Fax: 702-968-5004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: