Healthcare Provider Details

I. General information

NPI: 1508345786
Provider Name (Legal Business Name): J'AIME NICOLE MACPHERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9148 W LAKE MEAD BLVD STE. 316
LAS VEGAS NV
89134
US

IV. Provider business mailing address

10873 WALLFLOWER AVE
LAS VEGAS NV
89135-2862
US

V. Phone/Fax

Practice location:
  • Phone: 702-438-7800
  • Fax: 702-445-6454
Mailing address:
  • Phone: 702-672-3128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP5690
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: