Healthcare Provider Details

I. General information

NPI: 1083936645
Provider Name (Legal Business Name): ANDREA K VENDEIRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 S EASTERN AVE
LAS VEGAS NV
89123-2591
US

IV. Provider business mailing address

1742 PANDORA DR
LAS VEGAS NV
89123-1412
US

V. Phone/Fax

Practice location:
  • Phone: 702-439-3215
  • Fax:
Mailing address:
  • Phone: 702-439-3215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5702-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: