Healthcare Provider Details

I. General information

NPI: 1366966426
Provider Name (Legal Business Name): MONIQUE DAGEL MSW, LCSW, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5532 S FORT APACHE RD STE 110
LAS VEGAS NV
89148-7685
US

IV. Provider business mailing address

5532 S FORT APACHE RD STE 110
LAS VEGAS NV
89148-7685
US

V. Phone/Fax

Practice location:
  • Phone: 702-478-4046
  • Fax: 702-924-0630
Mailing address:
  • Phone: 702-478-4046
  • Fax: 702-924-0630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-1109
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: